Individual provider Active NPI

Mi Ok Kim, MSW

  • Home Health Aide
  • Bellflower, CA
National Provider Identifier
1639335615
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
17027 1/4 Clark Ave
Bellflower, CA 90706-5721
Phone
(562) 659-2030
Fax
(562) 867-3249
NPI assigned
Jul 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Primary

Addresses

Primary practice location

17027 1/4 Clark Ave
Bellflower, CA 90706-5721

Mailing address

17027 1/4 Clark Ave
Bellflower, CA 90706-5721
Phone (562) 659-2030

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

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1639335615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17027 1/4 CLARK AVE",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907065721",
            "telephone_number": "562-659-2030",
            "fax_number": "562-867-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17027 1/4 CLARK AVE",
            "city": "BELLFLOWER",
            "state": "CA",
            "postal_code": "907065721",
            "telephone_number": "562-659-2030",
            "fax_number": "562-867-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MI",
        "middle_name": "OK",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellflower, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.