Healthcare Provider Details

I. General information

NPI: 1942849328
Provider Name (Legal Business Name): TOTAL HEALTH INTEGRATIVE STRATEGIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 01/02/2020
Certification Date: 01/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W CALIFORNIA BLVD
PASADENA CA
91105-3010
US

IV. Provider business mailing address

3756 W AVENUE 40 STE 301
LOS ANGELES CA
90065-3665
US

V. Phone/Fax

Practice location:
  • Phone: 626-397-5000
  • Fax:
Mailing address:
  • Phone: 818-632-4202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLTON KIM
Title or Position: OWNER
Credential: M.D.
Phone: 818-632-4202