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NPI Code Detail

MEDICARE: HAYOUNG KIM

MEDICARE:   HAYOUNG  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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1073455440
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAYOUNG KIM
Provider Business Mailing Address
First Line : 100 W CALIFORNIA BLVD
Second Line :
City : PASADENA
State : CA
Zip : 91105-3010
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 W CALIFORNIA BLVD
Second Line :
City : PASADENA
State : CA
Zip : 91105-3010
Country : US
Telephone Number : 626-397-5166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2026
Last Update Date : 04/07/2026

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Directions to “ HAYOUNG KIM ” Practice Location

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