Most Relevant Information
Provider Data
| NPI Number: | 1003310517 |
| Provider Name: | CHANYOUNG KIM |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP2300X |
| Specialty: | Nurse Practitioner |
| License Number: | 95004688 |
Most Important Dates
| Enumeration Date: | 03/20/2018 |
| Last Updated: | 03/20/2018 |
Provider Practice Location
266 S HARVARD BLVD STE 100
LOS ANGELES
CA
900044374
Practice Location Phone/Fax
| Phone: | 2133818668 |
| Fax: |
Provider Mailing Location
266 S HARVARD BLVD STE 100
LOS ANGELES
CA
900044374
Provider Mailing Phone/Fax
| Phone: | 2133818668 |
| Fax: |