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General NPI Number Information
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NPI Number | 1144350661
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Entity Type | Organization
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Legal Business Name | YONG S KIM ACUPUNCTURE CLINIC INC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4160 WILSHIRE BLVD SUITE 301
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City | LOS ANGELES
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State | CA
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Zip | 90010-3569
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Country | US
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Telephone | 323-933-8814
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Fax | 323-933-8815
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Provider Business Mailing Address
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Address Line | 4160 WILSHIRE BLVD SUITE 301
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City | LOS ANGELES
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State | CA
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Zip | 90010-3569
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Country | US
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Telephone | 323-933-8814
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Fax | 323-933-8815
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. YONG SEOK KIM
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Credential | LAC PHD
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Telephone | 323-933-8814
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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 | AC7719
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License Number State | CA
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