Healthcare Provider Details

I. General information

NPI: 1598601049
Provider Name (Legal Business Name): KEVIN KYOUNGHUN KIM L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: KYOUNG HUN KIM

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 OSLER DR STE 303
TOWSON MD
21204-7702
US

IV. Provider business mailing address

306 W REDWOOD ST STE 4769
BALTIMORE MD
21201-1708
US

V. Phone/Fax

Practice location:
  • Phone: 410-505-7600
  • Fax:
Mailing address:
  • Phone: 410-505-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU03319
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: