Kim Antonio
Community Health Worker in Long Beach, CA. Individual provider (NPI-1).
NPI number1174027494
StatusActive
Last updated in NPPESMar 21, 2018
Details
- NPI
- 1174027494
- Entity type
- Individual (NPI-1)
- Name
- Kim Antonio
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 21, 2018
- Last updated
- Mar 21, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172V00000X | Community Health Worker | – | – | Yes |
Practice location
3530 Atlantic Ave Ste 210Long Beach, CA 90807-4569
Phone 562-424-1886
Mailing address
3530 Atlantic Ave Ste 210Long Beach, CA 90807-4569
Phone 562-424-1886
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