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NPI Code Detail

MEDICARE: JIEUN KIM

MEDICARE:   JIEUN  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
1101Y00000XCounselor

General Provider Information

NPI Number : 1841599347
Entity Type Code : Individual
Provider Name (Legal Business Name) : JIEUN KIM
Provider Business Mailing Address
First Line : 960 MAGNOLIA AVENUE APT 33
Second Line :
City : LOS ANGELES
State : CA
Zip : 90006
Country : US
Telephone Number : 213-291-5435
Fax Number :
Provider Business Practice Location Address
First Line : 1665 W ADAMS BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90007-1533
Country : US
Telephone Number : 323-731-3534
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2011
Last Update Date : 03/23/2011

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Directions to “ JIEUN KIM ” Practice Location

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