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General NPI Number Information
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NPI Number | 1437244548
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Entity Type | Individual
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Provider Name | SIMON C KIM L. AC.
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 115 E COMMONWEALTH AVE
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City | FULLERTON
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State | CA
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Zip | 92832-1907
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Country | US
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Telephone | 714-525-0452
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Fax | 714-525-1312
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Provider Business Mailing Address
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Address Line | 3439 CLIPPER DR
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City | CHINO HILLS
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State | CA
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Zip | 91709-3621
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Country | US
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Telephone | 213-268-8323
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Fax | 714-525-1312
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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 | AC10615
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License Number State | CA
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