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NPI Code Detail

MEDICARE: DEBORAH KIM

MEDICARE: DEBORAH KIM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner95001486CA

General Provider Information

NPI Number : 1033500483
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH KIM
Provider Business Mailing Address
First Line : PO BOX 35380
Second Line :
City : LAS VEGAS
State : NV
Zip : 89133-5380
Country : US
Telephone Number : 702-579-3203
Fax Number :
Provider Business Practice Location Address
First Line : 2750 E SLAUSON AVE
Second Line :
City : HUNTINGTON PARK
State : CA
Zip : 90255-3063
Country : US
Telephone Number : 323-583-3010
Fax Number : 323-581-2035
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2015
Last Update Date : 12/27/2025

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Directions to “ DEBORAH KIM ” Practice Location

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