Individual
MISS JISUN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
875 N BREA BLVD, BREA, CA 92821-2606
(714) 529-6842
Mailing address
6172 INDIANA AVE, BUENA PARK, CA 90621-2566
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
22683
CA
Other
Enumeration date
07/23/2020
Last updated
03/12/2022
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