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NPI Code Detail

MEDICARE: YURI KIM FNP

MEDICARE: YURI KIM FNP
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
1363L00000XNurse Practitioner95014894CA

General Provider Information

NPI Number : 1942939293
Entity Type Code : Individual
Provider Name (Legal Business Name) : YURI KIM FNP
Provider Business Mailing Address
First Line : 12865 MAIN ST STE 105
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92840-8205
Country : US
Telephone Number : 657-272-7877
Fax Number :
Provider Business Practice Location Address
First Line : 12865 MAIN ST STE 105
Second Line :
City : GARDEN GROVE
State : CA
Zip : 92840-8205
Country : US
Telephone Number : 657-272-7877
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2022
Last Update Date : 06/09/2022

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Directions to “ YURI KIM FNP” Practice Location

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