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General NPI Number Information
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NPI Number | 1386157816
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Entity Type | Individual
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Provider Name | ANDREW TAEHO KIM
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Gender | Male
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 10/12/2021
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Provider Practice Location Address
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Address Line | 2235 241ST ST APT 6
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City | LOMITA
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State | CA
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Zip | 90717-1062
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Country | US
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Telephone | 310-800-5614
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Fax |
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Provider Business Mailing Address
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Address Line | 2235 241ST ST APT 6
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City | LOMITA
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State | CA
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Zip | 90717-1062
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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 | 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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