MEDICARE: SOHYUN KELSO

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	:	1851233985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOHYUN KELSO

Provider Business Mailing Address
First Line	:	PO BOX 400637
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89140-0637
Country	:	US
Telephone Number	:	702-900-8689
Fax Number	:

Provider Business Practice Location Address
First Line	:	6655 W SAHARA AVE STE A206
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-2812
Country	:	US
Telephone Number	:	702-202-3383
Fax Number	:

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

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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Directions to “ SOHYUN KELSO ” Practice Location

Language	Start Address	Practice Location

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