Nicolette P Im

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

763293 Issued in CA

Practice address

25825 Vermont Ave
Harbor City, CA 90710-3518

Phone

(310) 517-3150

NPI assigned

Jan 31, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1255194668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 VANDERBILT LN APT 8",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783140",
            "telephone_number": "515-293-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25825 VERMONT AVE",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907103518",
            "telephone_number": "310-517-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IM",
        "first_name": "NICOLETTE",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "763293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Hwang
• Sarah Eunjoo Hwang, PHARM.D.
• Myra Ichikawa, RDN
• Almace Ignacio, OTR
• Kim I Ikemoto, OD
• Imagen & Chrystal Inc
• Ryokei K. Imai, MD
• Tracy May Imley, MD
• In Motion Physical Therapy and Rehab, Inc
• Sharon H Inada, AUD

• Registered Nurse in Harbor City, CA
• Providers in Harbor City, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.