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General NPI Number Information
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NPI Number | 1578812269
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Entity Type | Organization
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Legal Business Name | SRS KIM INC
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Dates
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Enumeration Date | 09/10/2012
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Last Update Date | 09/10/2012
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Provider Practice Location Address
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Address Line | 12450 CULVER BLVD 3305
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City | LOS ANGELES
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State | CA
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Zip | 90066
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Country | US
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Telephone | 310-266-9760
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Fax | 310-670-1914
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Provider Business Mailing Address
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Address Line | 5855 GREEN VALLEY CIRCLE., STE.201
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City | CULVER CITY
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State | CA
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Zip | 90230
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Country | US
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Telephone | 310-266-9760
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Fax | 310-670-1914
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SARAH KIM
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Credential | L.AC
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Telephone | 310-266-9760
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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 | 10029
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License Number State | CA
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