Active NPI
Mila Kim, P.T
- Physical Therapist
- Buena Park, CA
National Provider Identifier
1629202163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 35563
- Practice address
- 5610 River Way
#C
Buena Park, CA 90621-1744 - Phone
- (718) 873-7779
- NPI assigned
- May 12, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 35563 | CA | Primary |
| Physical Therapist | 225100000X | 024118 | NY |
Addresses
Primary practice location
5610 River Way
#C
Buena Park, CA 90621-1744
Mailing address
5610 River Way
#C
Buena Park, CA 90621-1744
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35563 | CA | MD | Physical Therapist |
| 024118 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242086400000",
"number": "1629202163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5610 RIVER WAY",
"address_2": "#C",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906211744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5610 RIVER WAY",
"address_2": "#C",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906211744",
"telephone_number": "718-873-7779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MILA",
"name_prefix": "Mrs.",
"credential": "P.T",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-12",
"last_updated": "2009-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "35563",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "024118",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buena Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.