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General NPI Number Information
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NPI Number | 1043709942
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Entity Type | Organization
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Legal Business Name | ACUMEDI HEALTH CENTER ACUPUNCTURE INC.
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 03/31/2020
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Provider Practice Location Address
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Address Line | 3400 W OLYMPIC BLVD STE 207
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City | LOS ANGELES
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State | CA
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Zip | 90019-2122
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Country | US
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Telephone | 213-365-2277
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Fax | 213-385-3710
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Provider Business Mailing Address
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Address Line | 3400 W OLYMPIC BLVD STE 207
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City | LOS ANGELES
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State | CA
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Zip | 90019-2122
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Country | US
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Telephone | 213-365-2277
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Fax | 213-385-3710
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Authorized Official
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Title or Position | CEO
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Name | JAE SEUNG KIM
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Credential | L.AC.
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Telephone | 213-365-2277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC4989
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License Number State | CA
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