MEDICARE: JUN YOUNG 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	CA3845	CA

General Provider Information

NPI Number	:	1770612152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUN YOUNG KIM

Provider Business Mailing Address
First Line	:	1020 S BRONSON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-3214
Country	:	US
Telephone Number	:	323-936-9330
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 S BRONSON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-3214
Country	:	US
Telephone Number	:	323-936-9330
Fax Number	:

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

Provider Enumeration Date	:	03/03/2007
Last Update Date	:	07/08/2007

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Directions to “ JUN YOUNG KIM ” Practice Location

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