MEDICARE: YOUNGKI KIM LAC

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	593	GA

General Provider Information

NPI Number	:	1659235026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOUNGKI KIM LAC

Provider Business Mailing Address
First Line	:	502 WINSTON CROFT CIR
Second Line	:
City	:	JOHNS CREEK
State	:	GA
Zip	:	30022-6718
Country	:	US
Telephone Number	:	470-949-1913
Fax Number	:

Provider Business Practice Location Address
First Line	:	2205 LAVISTA RD NE STE G
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-3951
Country	:	US
Telephone Number	:	770-710-8539
Fax Number	:	404-325-9874

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

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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Directions to “ YOUNGKI KIM LAC” Practice Location

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