Eunice Im, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

20789 Issued in CA

Practice address

8110 Airport Blvd
Los Angeles, CA 90045-3119

Phone

(310) 674-0144

Fax

(310) 674-1704

NPI assigned

Oct 11, 2011

Last updated

Mar 6, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1922383892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 AIRPORT BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453119",
            "telephone_number": "310-674-0144",
            "fax_number": "310-674-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 AIRPORT BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453119",
            "telephone_number": "310-674-0144",
            "fax_number": "310-674-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IM",
        "first_name": "EUNICE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "20789",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "20789",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA STATE LICENSE",
            "identifier": "20789",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Ilyina, LE
• Cho Hee Im
• Christina Im
• Daniel Im, M.D.
• Derrick Im
• Jane Im, NP
• Jihwon Im
• Jonah Im
• Kenneth Im, DPT
• Kyuseok Im

• Adult Health Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; 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.