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General NPI Number Information
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NPI Number | 1578346656
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Entity Type | Individual
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Provider Name | JOSHUA KIM
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Gender | Male
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 12203 SANTA MONICA BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90025-2517
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Country | US
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Telephone | 310-770-7586
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Fax |
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Provider Business Mailing Address
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Address Line | 5832 SATURN ST UNIT 2
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City | LOS ANGELES
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State | CA
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Zip | 90019-3741
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Country | US
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Telephone | 408-613-8513
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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 | 304614
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License Number State | CA
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