Provider Demographics
NPI:1902371297
Name:SUMLIN, K.
Entity Type:Individual
Prefix:
First Name:K.
Middle Name:
Last Name:SUMLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9901 ARTESIA BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-5650
Mailing Address - Country:US
Mailing Address - Phone:562-484-3385
Mailing Address - Fax:
Practice Address - Street 1:1680 E 120TH ST, LOS ANGELES
Practice Address - Street 2:
Practice Address - City:LOS ANGELES,
Practice Address - State:CA
Practice Address - Zip Code:90059
Practice Address - Country:US
Practice Address - Phone:424-454-6020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator