MEDICARE: ABRAHAM KIM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1548122369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABRAHAM KIM

Provider Business Mailing Address
First Line	:	PO BOX 1798
Second Line	:
City	:	RANCHO SANTA FE
State	:	CA
Zip	:	92067-1798
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12264 EL CAMINO REAL STE 101
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92130-3060
Country	:	US
Telephone Number	:	858-933-8118
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “ ABRAHAM KIM ” Practice Location

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