Search › California › 171100000X
Jong Wan Kim
NPI 1588406011 · on the registry since 2024
Practice
- Address
- 1904 N Tulare Way
Upland, CA 91784 - Phone
- (213) 800-5311
Registry record
- Primary taxonomy
- 171100000X
171100000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-06-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California