Healthcare Provider Details

I. General information

NPI: 1801748652
Provider Name (Legal Business Name): CHAE EUN KIM L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALINA CE KIM L.AC.

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 DALE CT
BREA CA
92821-3427
US

IV. Provider business mailing address

235 DALE CT
BREA CA
92821-3427
US

V. Phone/Fax

Practice location:
  • Phone: 214-701-7163
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC20463
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: