Provider Demographics
NPI:1457544660
Name:KIM, HYUNMIE LEE (NP)
Entity Type:Individual
Prefix:MRS
First Name:HYUNMIE
Middle Name:LEE
Last Name:KIM
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:11 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2302
Mailing Address - Country:US
Mailing Address - Phone:949-923-3277
Mailing Address - Fax:855-812-5865
Practice Address - Street 1:13930 SEAL BEACH BLVD
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-5301
Practice Address - Country:US
Practice Address - Phone:562-430-8888
Practice Address - Fax:562-799-0077
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2021-11-22
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Provider Licenses
StateLicense IDTaxonomies
CA10015363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHI056ZMedicare PIN