Most Relevant Information
Provider Data
| NPI Number: | 1003458977 |
| Provider Name: | JESSICA JAEHEE KIM PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AS0400X |
| Specialty: | Physician Assistant |
| License Number: | 57333 |
Most Important Dates
| Enumeration Date: | 10/11/2019 |
| Last Updated: | 06/29/2022 |
Provider Practice Location
4950 SAN BERNARDINO ST STE 200
MONTCLAIR
CA
917632328
Practice Location Phone/Fax
| Phone: | 9096217647 |
| Fax: |
Provider Mailing Location
2731 BRIERHAVEN DR
LA CRESCENTA
CA
912141403
Provider Mailing Phone/Fax
| Phone: | 8184840802 |
| Fax: |