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General NPI Number Information
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NPI Number | 1487926424
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Entity Type | Organization
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Legal Business Name | LIM ACUPUNCTURE & HERBS CLINIC, INC.
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Dates
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Enumeration Date | 02/07/2012
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Last Update Date | 12/10/2014
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Provider Practice Location Address
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Address Line | 3600 W OLYMPIC BLVD STE # 5
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City | LOS ANGELES
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State | CA
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Zip | 90019-2035
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Country | US
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Telephone | 213-351-1377
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Fax | 888-450-1242
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Provider Business Mailing Address
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Address Line | 3600 W OLYMPIC BLVD STE # 5
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City | LOS ANGELES
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State | CA
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Zip | 90019-2035
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Country | US
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Telephone | 213-351-1377
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Fax | 888-450-1242
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Authorized Official
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Title or Position | CEO
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Name | DR. KUNSEOB LIM
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Credential | L.AC.
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Telephone | 213-351-1377
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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 | AC11832
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License Number State | CA
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