Provider Demographics
NPI:1255789764
Name:KIM, JOEL GILHOI (DPT)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:GILHOI
Last Name:KIM
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 W ALAMEDA AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2802
Mailing Address - Country:US
Mailing Address - Phone:818-588-3880
Mailing Address - Fax:866-593-6794
Practice Address - Street 1:930 W ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2802
Practice Address - Country:US
Practice Address - Phone:818-588-3880
Practice Address - Fax:866-593-6794
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT43298225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist