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General NPI Number Information
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NPI Number | 1598198343
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Entity Type | Individual
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Provider Name | ILHYUNG KIM L.AC
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Gender | Male
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 04/01/2020
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Provider Practice Location Address
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Address Line | 835 S NORTON AVE APT 4
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City | LOS ANGELES
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State | CA
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Zip | 90005-3860
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Country | US
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Telephone | 714-745-3244
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Fax |
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Provider Business Mailing Address
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Address Line | 6437 MONTEZ CT
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95621-4355
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Country | US
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Telephone | 913-260-9324
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Fax |
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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 | AC15472
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License Number State | CA
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