Healthcare Provider Details

I. General information

NPI: 1891476826
Provider Name (Legal Business Name): JULIA HYERIN KIM FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2023
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 WILSHIRE BLVD STE 804
LOS ANGELES CA
90017-4808
US

IV. Provider business mailing address

2012 W 236TH ST
TORRANCE CA
90501-6052
US

V. Phone/Fax

Practice location:
  • Phone: 213-482-2770
  • Fax: 562-967-2468
Mailing address:
  • Phone: 310-755-5292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95026325
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: