| Provider / Organization | NPI | Date Certified |
|---|---|---|
| CRYSTAL KIM | 1528674017 | 2021-10-06 |
Crystal Kim is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1528674017. Registration indicates Crystal Kim is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Crystal Kim NP |
| Practice Office Address | 900 E WASHINGTON ST STE 301 COLTON, CA US |
| Practice Office Telephone | 9093700300 |
| Mailing Address | 900 E WASHINGTON ST STE 301 COLTON, CA 923248182 US |
| Business Telephone | 5599404710 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 900 E Washington St Ste 301 | Colton, CA 923248182 | 9093700300 |
| 999 N Tustin Ave Ste 201 | Santa Ana, CA 927056506 | 7149757950 |
| 228 W Markland Dr | Monterey Park, CA 917547115 | 5599404710 |
| Code | Practice | License No State |
|---|---|---|
| 363L00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner All Other Specialties & Provider Types Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers | 95015248
CA |