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General NPI Number Information
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NPI Number | 1043684863
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Entity Type | Individual
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Provider Name | EUNICE KIM APN
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Gender | Female
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Dates
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Enumeration Date | 11/17/2015
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 23456 HAWTHORNE BLVD STE 260
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City | TORRANCE
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State | CA
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Zip | 90505-4716
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Country | US
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Telephone | 424-212-6200
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Fax | 424-212-6250
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Provider Business Mailing Address
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Address Line | PO BOX 512185
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City | LOS ANGELES
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State | CA
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Zip | 90051-0185
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95009602
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License Number State | CA
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