Provider Demographics
NPI:1184420564
Name:LIM, HYE KYOUNG (FNP-C)
Entity type:Individual
Prefix:
First Name:HYE KYOUNG
Middle Name:
Last Name:LIM
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-2810
Mailing Address - Country:US
Mailing Address - Phone:310-904-5780
Mailing Address - Fax:
Practice Address - Street 1:2727 W OLYMPIC BLVD STE 208
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2640
Practice Address - Country:US
Practice Address - Phone:213-908-6434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF11240653363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily