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NPI Code Detail

MEDICARE: MILI KIM

MEDICARE: MILI 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
1225400000XRehabilitation Practitioner
2390200000XStudent in an Organized Health Care Education/Training Program
3106H00000XMarriage & Family Therapist128569CA

General Provider Information

NPI Number : 1760005169
Entity Type Code : Individual
Provider Name (Legal Business Name) : MILI KIM
Provider Business Mailing Address
First Line : 897 GRANITE DR
Second Line :
City : PASADENA
State : CA
Zip : 91101-3501
Country : US
Telephone Number : 626-993-3000
Fax Number :
Provider Business Practice Location Address
First Line : 897 GRANITE DR
Second Line :
City : PASADENA
State : CA
Zip : 91101-3501
Country : US
Telephone Number : 626-993-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2020
Last Update Date : 10/11/2021

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Directions to “ MILI KIM ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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