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General NPI Number Information
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NPI Number | 1407593064
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Entity Type | Individual
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Provider Name | SONGHYUN KIM L.AC
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Gender | Female
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Dates
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Enumeration Date | 05/16/2022
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 338 N WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90004-2602
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Country | US
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Telephone | 213-250-5106
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Fax | 213-250-8861
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Provider Business Mailing Address
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Address Line | 351 S FULLER AVE APT 4B
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City | LOS ANGELES
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State | CA
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Zip | 90036-5459
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Country | US
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Telephone | 808-428-6828
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 19461
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License Number State | CA
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