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NPI Code Detail

MEDICARE: SUZANNE KIM

MEDICARE: SUZANNE 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
1103K00000XBehavior Analyst5010TX
2247200000XOther Technician

General Provider Information

NPI Number : 1962893206
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE KIM
Provider Business Mailing Address
First Line : PO BOX 33568
Second Line :
City : SAN DIEGO
State : CA
Zip : 92163-3568
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-374-7134
Provider Business Practice Location Address
First Line : 5022 TENNYSON PKWY
Second Line :
City : PLANO
State : TX
Zip : 75024-3151
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-374-7134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2015
Last Update Date : 09/03/2025

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Directions to “ SUZANNE KIM ” Practice Location

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