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General NPI Number Information
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NPI Number | 1528698131
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Entity Type | Organization
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Legal Business Name | GILEAD ACUPUNCTURE INC. DBA KIM'S ACUPUNCTURE
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Dates
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Enumeration Date | 01/23/2020
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 711 S VERMONT AVE STE 113
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City | LOS ANGELES
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State | CA
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Zip | 90005-1587
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Country | US
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Telephone | 213-718-2115
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Fax |
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Provider Business Mailing Address
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Address Line | 1256 BOYNTON ST APT 16
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City | GLENDALE
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State | CA
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Zip | 91205-3441
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Country | US
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Telephone | 213-718-2115
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | CHUL UN KIM
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Credential | LAC.
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Telephone | 213-718-2115
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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 |
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License Number State |
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