MEDICARE: MISS MIMI WHANG RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	817168	CA

General Provider Information

NPI Number	:	1891030854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MIMI WHANG RN

Provider Business Mailing Address
First Line	:	1401 N HANDY ST
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92867-4434
Country	:	US
Telephone Number	:	714-628-5817
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 N HANDY ST
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92867-4434
Country	:	US
Telephone Number	:	714-628-5817
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2012
Last Update Date	:	03/13/2026

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