=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366760449
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MS. LINDA S. KIM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/13/2010
-----------------------------------------------------
Last Update Date | 04/23/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 70 SARATOGA AVE
-----------------------------------------------------
City | SANTA CLARA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95051-7381
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-246-7700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 70 SARATOGA AVE
-----------------------------------------------------
City | SANTA CLARA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95051-7301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-246-7700
-----------------------------------------------------
Fax | 408-246-7707
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AC7065
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------