Doctor Name: | MRS. MICHELLE LARA KIM |
NPI Number: | 1851535413 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | O.T.R./L |
License Number: | OT 2282 |
Business Practice Address: | 9161 Sierra Ave Suite 111 Fontana, CA - 923354729 |
Business Phone Number: | 9094274073 |
Business Fax Number: | |
Mailing Address: | 26430 Margarita Ln, LOMA LINDA |
State: | CA |
Postal Code: | 923546741 |
Phone Number: | 9092103892 |
Fax Number: | |
NPI Enumeration Date: | 04/27/2009 |
NPI Last Update Date: | 12/30/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | OT 2282 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |