Individual
KIM M. HARGIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6041 CADILLAC AVE, LOS ANGELES, CA 90034-1702
(323) 857-2000
Mailing address
393 E WALNUT ST, PHR GROUP & PROVIDER ENROLLMENT UNIT, 3RD FLR, PASADENA, CA 91188-0001
(626) 405-7966
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
036108200
IL
2083X0100X
Occupational Medicine Physician
036108200
IL
208600000X
Surgery Physician
Primary
A84435
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A844350
—
CA
Enumeration date
01/17/2007
Last updated
03/05/2025
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