Provider Demographics
NPI:1770316705
Name:YI, KATHLEEN AH RIN
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:AH RIN
Last Name:YI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 BROWNING BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-1608
Mailing Address - Country:US
Mailing Address - Phone:562-505-4188
Mailing Address - Fax:
Practice Address - Street 1:3200 W TEMPLE ST STE 100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-7372
Practice Address - Country:US
Practice Address - Phone:562-505-4188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program