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General NPI Number Information
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NPI Number | 1568534006
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Entity Type | Individual
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Provider Name | MR. EUN SANG SANG KIM
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Gender | Male
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 951 S WESTLAKE BLVD STE 110
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361
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Country | US
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Telephone | 805-371-0058
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Fax | 805-371-0058
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Provider Business Mailing Address
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Address Line | 951 S WESTLAKE BLVD STE 110
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361
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Country | US
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Telephone | 805-371-0058
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Fax | 805-371-0058
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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 | AC 9341
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License Number State | CA
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