Provider Demographics
NPI:1598245979
Name:BIM, NATHELIA (NP)
Entity Type:Individual
Prefix:MRS
First Name:NATHELIA
Middle Name:
Last Name:BIM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 SAN GABRIEL BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-4394
Mailing Address - Country:US
Mailing Address - Phone:323-724-0019
Mailing Address - Fax:323-248-7044
Practice Address - Street 1:2237 W BALL RD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804
Practice Address - Country:US
Practice Address - Phone:714-490-2750
Practice Address - Fax:714-490-2757
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP950092363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health