Doctor Name: | AILENE KIM |
NPI Number: | 1184707010 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ASW REGISTERED |
License Number: | |
Business Practice Address: | 17707 Studebaker Rd Cerritos, CA - 907032640 |
Business Phone Number: | 5624020688 |
Business Fax Number: | |
Mailing Address: | 520 So. Lafayette Park Place 3rd Floor, LA |
State: | CA |
Postal Code: | 90057 |
Phone Number: | 2132522100 |
Fax Number: | 2133833146 |
NPI Enumeration Date: | 10/23/2006 |
NPI Last Update Date: | 08/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |