Healthcare Provider Details

I. General information

NPI: 1801705660
Provider Name (Legal Business Name): JU LI KIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/05/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8268 CLEVELAND AVE
OAK HILLS CA
92344-7007
US

IV. Provider business mailing address

8268 CLEVELAND AVE
OAK HILLS CA
92344-7007
US

V. Phone/Fax

Practice location:
  • Phone: 818-933-1215
  • Fax:
Mailing address:
  • Phone: 818-933-1215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number20742
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: