| David Kim, AGACNP-BC | |
|
16723 Vanowen St, Lake Balboa, CA 91406-4638 | |
| (818) 279-1745 | |
| Not Available |
| Full Name | David Kim |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Acute Care |
| Location | 16723 Vanowen St, Lake Balboa, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447967682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LA2100X | Nurse Practitioner - Acute Care | 95021554 (California) | Primary |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
| Entity Name | Mend Health Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467849745 PECOS PAC ID: 6406160803 Enrollment ID: O20150729008949 |
| Mailing Address | Practice Location Address |
|---|---|
| David Kim, AGACNP-BC 16723 Vanowen St, Lake Balboa, CA 91406-4638 Ph: (818) 279-1745 | David Kim, AGACNP-BC 16723 Vanowen St, Lake Balboa, CA 91406-4638 Ph: (818) 279-1745 |
Lovelle Christine Valencia, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6856 Petit Ave, Lake Balboa, CA 91406 Phone: 818-741-7436 | |
Luiza Kazaryan, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6858 Mclennan Ave, Lake Balboa, CA 91406 Phone: 818-903-0521 |