Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | A157693 | CA |
NPI | 1871028894 |
---|---|
Provider Name | Danny N Nieves-Kim |
First Address | Brooklyn, NY 11217-4898 |
Second Address | Harbor City, CA 90710-2076 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2017 |
Last Update Date | 14/07/2021 |