Healthcare Provider Details

I. General information

NPI: 1275418352
Provider Name (Legal Business Name): MISS HALLIE EMI KAICHI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2025
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1891 EFFIE ST
LOS ANGELES CA
90026-1711
US

IV. Provider business mailing address

6555 MONTAIRE PL
LA PALMA CA
90623-1057
US

V. Phone/Fax

Practice location:
  • Phone: 323-644-2000
  • Fax:
Mailing address:
  • Phone: 562-355-5874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: