Miju Kim, OTD

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT 9289 Issued in CA

Practice address

3700 Park PL
Montrose, CA 91020-1623

Phone

(818) 637-2127

NPI assigned

Nov 23, 2007

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wellspring Therapy Inc

  • Customized Equipment (DME)
  • Glendale, CA
  • NPI 1801001508
  NPD (past)
• Wellspring Therapy, Inc

  • Physical Therapist
  • Glendale, CA
  • NPI 1538266002
  NPD (past)

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

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195776000000",
    "number": "1528249273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 PARK PL",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 PARK PL",
            "city": "MONTROSE",
            "state": "CA",
            "postal_code": "910201623",
            "telephone_number": "818-637-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MIJU",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-23",
        "last_updated": "2007-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "OT 9289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra T Kessler, PSY.D.
• Zohrab Khacheryan
• Elena Khavshaba
• In Woo Kim
• Julie Eunkyung Kim, D.D.S.
• Kinetic Conditioning Institute, Inc
• Christine Alain Kreger, LMFT
• La Crescenta Hospice Inc
• Brian John Le Clair, PHD LMFT
• Yeon Lee-Woodley, MS CCC-SLP

• Pediatric Occupational Therapist in Montrose, CA
• Providers in Montrose, CA by specialty
• Pediatric Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; 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.