Provider Demographics
NPI:1982189742
Name:KIM, EUN Z (AUD)
Entity Type:Individual
Prefix:
First Name:EUN
Middle Name:Z
Last Name:KIM
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:RUDI
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8631 W. 3RD ST. SUITE 312E
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:949-364-4361
Mailing Address - Fax:949-364-7124
Practice Address - Street 1:8631 W. 3RD ST. SUITE 312E
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-652-4327
Practice Address - Fax:310-652-7900
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU3366237600000X
AU3366231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter