TAE YOUN KIM


Address: 1505 Wilson Ter Ste 250, Glendale, CA 91206-4075
Phone: 8182467115

TAE YOUN KIM (NPI# 1215451729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215451729
Entity Type Individual
Full Name TAE YOUN KIM
Practice Address 1505 Wilson Ter Ste 250
Glendale
CA 91206-4075
Practice Telephone 8182467115
Enumeration Date 2017-07-27
Last Update Date 2017-08-04
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
95006892 CA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1505 WILSON TER STE 250
City GLENDALE
State CA
Zip Code 91206-4075

Providers in the same location

NPI Name Taxonomy Address Enumeration
1710409131 Lisa Weber Acupuncturist 1505 Wilson Ter Ste 250, Glendale, CA 91206-4075 2017-07-07
1174026926 Edmund H. Lew, Md, Inc Family Medicine 1505 Wilson Ter Ste 250, Glendale, CA 91206-4075 2018-03-16

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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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Competitor

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City GLENDALE
Zip Code 91206

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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