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General NPI Number Information
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NPI Number | 1629233234
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Entity Type | Individual
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Provider Name | YOUNGHOON KIM PT,DPT,OCS,CSCS
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Gender | Male
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 09/08/2010
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Provider Practice Location Address
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Address Line | 42301 10TH ST W
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City | LANCASTER
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State | CA
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Zip | 93534-7000
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Country | US
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Telephone | 661-942-2202
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Fax | 661-942-2203
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Provider Business Mailing Address
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Address Line | PO BOX 5203
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City | LANCASTER
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State | CA
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Zip | 93539
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Country | US
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Telephone | 661-942-2202
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Fax | 661-942-2203
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 27406
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License Number State | CA
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