MEDICARE: KARIM MEDINA

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1649086737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARIM MEDINA

Provider Business Mailing Address
First Line	:	11848 LANSDALE AVE APT 14
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91732-4203
Country	:	US
Telephone Number	:	626-625-7374
Fax Number	:

Provider Business Practice Location Address
First Line	:	5800 PACIFIC BLVD
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-2618
Country	:	US
Telephone Number	:	888-969-4427
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2024
Last Update Date	:	12/04/2024

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Directions to “ KARIM MEDINA ” Practice Location

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