| NPI | 1477362952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIDEUM TIMOTHY KIM Nurse Practitioner 714-512-1319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-12-30 |
| Last Update Date | 2024-12-30 |