=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245452564
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HANMAEUM SENIOR SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/03/2007
-----------------------------------------------------
Last Update Date | 11/07/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2001 W. OLYMPIC BLVD
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90006-3705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-736-0001
-----------------------------------------------------
Fax | 213-736-6581
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2001 W. OLYMPIC BLVD
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90006-3705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-736-0001
-----------------------------------------------------
Fax | 213-736-6581
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MR. JINWOO KIM
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 213-731-0001
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA0600X
-----------------------------------------------------
Taxonomy Name | Adult Day Care Clinic/Center
-----------------------------------------------------
License Number | 060000639
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------