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General NPI Number Information
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NPI Number | 1144945189
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Entity Type | Individual
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Provider Name | BENNETH BUNDIT KIM PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 01/18/2025
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Provider Practice Location Address
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Address Line | 4200 CHINO HILLS PKWY STE 825
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City | CHINO HILLS
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State | CA
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Zip | 91709-5832
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Country | US
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Telephone | 310-808-7612
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Fax |
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Provider Business Mailing Address
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Address Line | 20516 EARL ST
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City | TORRANCE
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State | CA
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Zip | 90503-3007
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Country | US
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Telephone | 310-808-7612
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 302944
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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