Doctor Name: | MR. SUNG W. KIM |
NPI Number: | 1326262502 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.DIV. |
License Number: | |
Business Practice Address: | 18623 Gale Ave City Of Industry, CA - 917481342 |
Business Phone Number: | 6268390300 |
Business Fax Number: | |
Mailing Address: | 17109 Highwood Rd, HACIENDA HEIGHTS |
State: | CA |
Postal Code: | 917456757 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |