MEDICARE: JESSICA 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
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1831590009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA KIM

Provider Business Mailing Address
First Line	:	457 N SIERRA BONITA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-2407
Country	:	US
Telephone Number	:	818-405-8224
Fax Number	:

Provider Business Practice Location Address
First Line	:	457 N SIERRA BONITA AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-2407
Country	:	US
Telephone Number	:	818-405-8224
Fax Number	:

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

Provider Enumeration Date	:	09/08/2014
Last Update Date	:	09/08/2014

Similar Medicare Providers

1881722650 — MR. DANIEL WEI-KONG CHU LCSW
Practice Location Address:

457 N SIERRA BONITA AVE
LOS ANGELES, CA
90036-2407

Practice Phone: 818-952-6648
Practice Fax:

1386787976 — DR. ARTURO IBARRA D.D.S.
Practice Location Address:

2407 N BROADWAY AVE.
LOS ANGELES, CA
90031-2218

Practice Phone: 323-221-3165
Practice Fax: 323-221-0112

1295867414 — AQUILEO MARTINEZ D.D.S., INC.
Practice Location Address:

4521 WHITTIER BLVD
LOS ANGELES, CA
90022-2407

Practice Phone: 323-261-4838
Practice Fax: 323-261-6399

1497969448 — DR. FARNAZ TOFIGH DDS
Practice Location Address:

1561 W PICO BLVD
LOS ANGELES, CA
90015-2407

Practice Phone: 213-251-9994
Practice Fax: 213-251-9796

1154651784 — UNIVERSITY OF SOUTHERN CALIFORNIA
Practice Location Address:

1441 EASTLAKE AVE , # 2407
LOS ANGELES, CA
90089-0112

Practice Phone: 323-865-3000
Practice Fax: 323-865-3868

1306154380 — ANARAKI DENTAL CORPORATION
Practice Location Address:

1561 W PICO BLVD
LOS ANGELES, CA
90015-2407

Practice Phone: 213-251-9994
Practice Fax: 213-251-9796

Directions to “ JESSICA KIM ” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.