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General NPI Number Information
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NPI Number | 1760951891
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Entity Type | Individual
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Provider Name | HEE KYUNG KIM OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/19/2018
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Last Update Date | 11/19/2018
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Provider Practice Location Address
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Address Line | 5980 W PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90035-2657
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Country | US
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Telephone | 626-354-1584
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Fax |
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Provider Business Mailing Address
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Address Line | 1136 DIAMOND AVE APT A
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-5725
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Country | US
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Telephone | 818-331-5866
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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 | 225XM0800X
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Taxonomy Name | Mental Health Occupational Therapist
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License Number | 18692
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License Number State | CA
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