Provider Demographics
NPI:1043006075
Name:KIM, SEAN YOOSIN (PT, DPT)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:YOOSIN
Last Name:KIM
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16011 BUTTERFIELD RANCH RD UNIT 428
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-7458
Mailing Address - Country:US
Mailing Address - Phone:213-393-0247
Mailing Address - Fax:
Practice Address - Street 1:1561 E ONTARIO AVE STE 101
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-6663
Practice Address - Country:US
Practice Address - Phone:951-407-9233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307745225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist