Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 143471 | CA |
NPI | 1245556356 |
---|---|
Provider Name | Jessica Kim Signoff |
First Address | Sacramento, CA 95817-2208 |
Second Address | Sacramento, CA 95817-2208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2010 |
Last Update Date | 08/07/2016 |