Kim, Moon Ju

Kim, Moon Ju is an individual health care provider with primary practice located at 1058 S Vermont Ave , Los Angeles CA 90006-2721. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Women's Health, which is considered as her primary health care specialty. Kim, Moon Ju can be contacted via phone (213) 380-8833.

Contact Information

Primary practice address
1058 S Vermont Ave Los Angeles CA 90006-2721
Phone: (213) 380-8833
Fax: (213) 368-6047
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X NP8434 California

Profile Details

NPI number 1679787766
LBN Legal business name Kim, Moon Ju
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2007
Last updated May 8th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679787766 NPPES
California MEDICAID NP0084340

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