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General NPI Number Information
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NPI Number | 1629156567
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Entity Type | Individual
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Provider Name | HYUN KYU KIM
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4416 BEVERLY BLVD.
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City | LOS ANGELES
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State | CA
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Zip | 90004
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Country | US
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Telephone | 323-668-9007
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Fax |
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Provider Business Mailing Address
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Address Line | 17027 1/4 CLARK AVE
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City | BELLFLOWER
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State | CA
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Zip | 90706-5721
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Country | US
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Telephone | 562-659-2030
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1904301100
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License Number State | CA
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