Provider Demographics
NPI:1144843848
Name:KIM, HARRY HANWOOL
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:HANWOOL
Last Name:KIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:HANWOOL
Other - Middle Name:HARRY
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4733 W SUNSET BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6021
Mailing Address - Country:US
Mailing Address - Phone:888-576-3348
Mailing Address - Fax:
Practice Address - Street 1:98 S LOS ROBLES AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2433
Practice Address - Country:US
Practice Address - Phone:888-576-3348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program