Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | G82040 | CA |
NPI | 1235451360 |
---|---|
Provider Name | Dr. Janet Bonnie Kim |
First Address | Mission Viejo, CA 92691-5380 |
Second Address | Mission Viejo, CA 92691-5380 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2010 |
Last Update Date | 27/04/2021 |