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General NPI Number Information
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NPI Number | 1578255964
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Entity Type | Individual
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Provider Name | NATALIA KIM
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Gender | Female
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Dates
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Enumeration Date | 05/23/2023
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 8485 TAMARIND AVE
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City | FONTANA
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State | CA
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Zip | 92335-3975
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Country | US
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Telephone | 909-356-6852
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Fax |
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Provider Business Mailing Address
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Address Line | 11584 CEDAR WAY
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City | LOMA LINDA
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State | CA
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Zip | 92354-3604
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Country | US
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Telephone | 347-256-8235
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 110674
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License Number State | CA
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