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General NPI Number Information
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NPI Number | 1174529267
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Entity Type | Individual
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Provider Name | ANADELIA B KIM NP
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Gender | Female
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1800 SULLIVAN AVE
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City | DALY CITY
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State | CA
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Zip | 94015-2228
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Country | US
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Telephone | 650-992-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 611 VIEWRIDGE DR
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City | PACIFICA
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State | CA
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Zip | 94044-2162
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 14765
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License Number State | CA
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