Healthcare Provider Details

I. General information

NPI: 1235056482
Provider Name (Legal Business Name): IATREON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12264 EL CAMINO REAL STE 101
SAN DIEGO CA
92130-3060
US

IV. Provider business mailing address

PO BOX 1798
RANCHO SANTA FE CA
92067-1798
US

V. Phone/Fax

Practice location:
  • Phone: 858-933-8118
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. ABRAHAM KIM
Title or Position: CEO
Credential: DACM
Phone: 858-933-8118