Healthcare Provider Details

I. General information

NPI: 1093824369
Provider Name (Legal Business Name): LOMITA HEALTH MANAGEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1234 LOMITA BOULEVARD SUITE E
HARBOR CITY CA
90710-2147
US

IV. Provider business mailing address

1234 LOMITA BOULEVARD SUITE E
HARBOR CITY CA
90710-2147
US

V. Phone/Fax

Practice location:
  • Phone: 310-539-4800
  • Fax: 310-539-4813
Mailing address:
  • Phone: 310-539-4800
  • Fax: 310-539-4813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number06000862
License Number StateCA

VIII. Authorized Official

Name: MR. TAEWOONG KIM
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 310-539-4800