HUMBLED ONE NURSING GROUP CORP NPI 1073360467

NPI Information

  • NPI: 1073360467
  • Provider Name: HUMBLED ONE NURSING GROUP CORP
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: PRIMARY CARE AND IV
  • CLIA Number: 05D2306910
  • Address: 5471 LA PALMA AVE STE 105
    LA PALMA, CA
    ZIP 90623
  • Phone: (714) 695-2388

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NPI Details

HUMBLED ONE NURSING GROUP CORP is a primary care nurse practitioner in La Palma, CA. HUMBLED ONE NURSING GROUP CORP NPI is 1073360467. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Primary Care And Iv.

The provider's business location address is:

5471 LA PALMA AVE STE 105
LA PALMA, CA
ZIP 90623-773
Phone: (714) 695-2388
Fax: (714) 695-2391

The provider's authorized official is Namju Kim Shin .
The authorized official title is Ceo and has the following contact phone number (714) 695-2388.

The CLIA number assigned to this NPI record is 05D2306910 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/2/2024 and was last updated on 12/14/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP2300XNurse PractitionerPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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