Active NPI
Min Seop Kim, MS
- Behavior Analyst
- Gardena, CA
National Provider Identifier
1639729569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-23-69112
- Practice address
- 1411 W 190TH St
Gardena, CA 90248-4324 - Phone
- (310) 719-3908
- NPI assigned
- Sep 12, 2019
- Reactivated
- Feb 21, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-23-69112 | CA | Primary |
Addresses
Primary practice location
1411 W 190TH St
Gardena, CA 90248-4324
Mailing address
25930 Rolling Hills Rd Apt 403
Torrance, CA 90505-7203
Other practice location 1
3200 E Guasti Rd Ste 100
Ontario, CA 91761-8661
Phone (626) 388-0498
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788998400000",
"number": "1639729569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25930 ROLLING HILLS RD APT 403",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905057203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1411 W 190TH ST",
"city": "GARDENA",
"state": "CA",
"postal_code": "902484324",
"telephone_number": "310-719-3908"
}
],
"practiceLocations": [
{
"address_1": "3200 E Guasti Rd Ste 100",
"address_purpose": "LOCATION",
"city": "Ontario",
"state": "CA",
"postal_code": "917618661",
"country_code": "US",
"telephone_number": "626-388-0498",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "MIN SEOP",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-12",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"deactivation_date": "2020-07-16",
"reactivation_date": "2023-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CA",
"license": "1-23-69112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.