Power Healing Medical Center, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

CA18720 Issued in CA

Legal business name

POWER HEALING MEDICAL CENTER, INC.

Practice address

1251 W Redondo Beach Blvd FL 3
Gardena, CA 90247-3464

Phone

(310) 965-0500

Fax

(310) 965-0055

NPI assigned

Jul 23, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Joong Gap Kim, MD

Title

President

Phone

(310) 965-0500

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1500768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1568985463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 W REDONDO BEACH BLVD FL 3",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473464",
            "telephone_number": "310-965-0500",
            "fax_number": "310-965-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 W REDONDO BEACH BLVD FL 3",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473464",
            "telephone_number": "310-965-0500",
            "fax_number": "310-965-0055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9764 Garden Grove Blvd",
            "address_purpose": "LOCATION",
            "city": "Garden Grove",
            "state": "CA",
            "postal_code": "928441615",
            "country_code": "US",
            "telephone_number": "714-534-0007",
            "fax_number": "714-534-0004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4021 Orange Ave",
            "address_purpose": "LOCATION",
            "city": "Cypress",
            "state": "CA",
            "postal_code": "906302715",
            "country_code": "US",
            "telephone_number": "714-828-0008",
            "fax_number": "714-828-0007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "POWER HEALING MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-23",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JOONG",
        "authorized_official_middle_name": "GAP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-965-0500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A39214",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "CA18720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861527897",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Gardena, CA
• Providers in Gardena, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.