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General NPI Number Information
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NPI Number | 1861132250
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Entity Type | Individual
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Provider Name | JENNIFER YOUNG KIM MD
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Gender | Female
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Dates
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Enumeration Date | 04/01/2022
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 1300 S SUNSET AVE
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City | WEST COVINA
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State | CA
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Zip | 91790-3342
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Country | US
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Telephone | 626-960-6999
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Fax | 626-960-5246
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Provider Business Mailing Address
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Address Line | 1300 S SUNSET AVE
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City | WEST COVINA
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State | CA
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Zip | 91790-3342
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Country | US
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Telephone | 626-960-6999
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Fax | 626-960-5246
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A202453
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License Number State | CA
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