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General NPI Number Information
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NPI Number | 1457550345
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Entity Type | Organization
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Legal Business Name | YOUNG KIM NP NURSING, PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 12/14/2007
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Provider Practice Location Address
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Address Line | 2227 OLD BARN LN
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City | CHULA VISTA
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State | CA
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Zip | 91915-1946
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Country | US
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Telephone | 619-990-8827
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Fax |
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Provider Business Mailing Address
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Address Line | 2227 OLD BARN LN
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City | CHULA VISTA
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State | CA
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Zip | 91915-1946
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Country | US
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Telephone | 619-990-8827
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. YOUNGMI P KIM
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Credential | ANP
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Telephone | 619-990-8827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | NP 13780
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License Number State | CA
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