Individual
CHRISTINA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
18700 BEACH BLVD, SUITE120, HUNTINGTON BEACH, CA 92648-2030
(714) 962-6760
(714) 962-5961
Mailing address
18700 BEACH BLVD, SUITE120, HUNTINGTON BEACH, CA 92648-2030
(714) 962-6760
(714) 962-5961
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
017400
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT0017400
BLUE SHIELD PROVIDER
CA
Enumeration date
12/27/2006
Last updated
07/08/2007
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