| Hannah Suh Kim, PA | |
|
9961 Sierra Ave, Fontana, CA 92335-6720 | |
| (909) 427-5000 | |
| Not Available |
| Full Name | Hannah Suh Kim |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Medical |
| Location | 9961 Sierra Ave, Fontana, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487962288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | IN THE PROCESS (California) | Secondary |
| 363AM0700X | Physician Assistant - Medical | PA21208 (California) | Primary |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823 |
| Mailing Address | Practice Location Address |
|---|---|
| Hannah Suh Kim, PA 9961 Sierra Ave, Fontana, CA 92335-6720 Ph: Not Available | Hannah Suh Kim, PA 9961 Sierra Ave, Fontana, CA 92335-6720 Ph: (909) 427-5000 |
Maralee Shadle, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910 |
Ms. Cindy Ellen Tetzlaff, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 10650 Sierra Ave Ste B, Fontana, CA 92337 Phone: 909-550-3320 |
Annika Joshi, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 7459 Vicksburg Pl, Fontana, CA 92336 Phone: 909-243-2107 |
Randall D Sellon, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910 |
Gulbag Singh Kahlon, PHYSICIAN ASSOCIATE Physician Assistant Medicare: Medicare Enrolled Practice Location: 5890 Ventana Dr, Fontana, CA 92336 Phone: 909-275-1744 |
Christopher Blanchfield, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910 |
Giuliana Cilliani, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 16465 Sierra Lakes Pkwy Ste 300, Fontana, CA 92336 Phone: 909-429-2864 |