Individual provider · Type 1 NPI
Jessica Jaehee Kim, PA-C
Surgical Physician Assistant · Montclair, CA
NPI number
1003458977
Active
Practice location
4950 San Bernardino St Ste 200
Montclair, CA 91763-2328
Mailing address
2731 Brierhaven Dr
La Crescenta, CA 91214-1403
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | 57333 (CA) |
Surgical Physician Assistant: Definition to come...
About NPI 1003458977
Jessica Jaehee Kim, PA-C's National Provider Identifier is 1003458977, issued on Oct 11, 2019. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Montclair, CA. The record was last updated on Jun 29, 2022.