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1336970052
KISUP RHIM
BUENA PARK, CA
NPI
1336970052
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CA 95027432)
Enumeration Date
2024-08-13
Last Update Date
2024-08-13
Business Address
KISUP RHIM FNP
5731 BEACH BLVD ROOM 202
BUENA PARK, CA 90621
Phone number: 213-503-7769
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Mailing Address
KISUP RHIM FNP
165 REED LAND
LA HABRA, CA 90631
Phone number: 213-503-7769
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