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Individual
MIJIN DO
Active
Individual
MIJIN DO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95040025
CA
363LF0000X
Family Nurse Practitioner
Primary
95009374
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95040025
RN
CA
Enumeration date
06/30/2018
Last updated
07/17/2018
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