Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jisoo Kim

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1083308290

Jisoo Kim is a Student in an Organized Health Care Education/Training Program in Toluca Lake, California. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

10740 Moorpark St
Toluca Lake, CA 91602-3602
Phone: (213) 568-7663
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1083308290
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 8, 2023
Last updated in NPPESJune 8, 2023
Certification dateJune 5, 2023
Mailing address10740 Moorpark St, Toluca Lake, CA 91602-3602