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General NPI Number Information
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NPI Number | 1659810786
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Entity Type | Organization
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Legal Business Name | KIM'S ACUPUNCTURE, INC
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Dates
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Enumeration Date | 02/22/2017
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Last Update Date | 10/05/2017
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Provider Practice Location Address
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Address Line | 16250 VENTURA BLVD STE 450
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City | ENCINO
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State | CA
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Zip | 91436-2204
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Country | US
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Telephone | 818-809-1009
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Fax | 818-809-1009
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Provider Business Mailing Address
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Address Line | 18500 MAYALL ST H
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City | NORTHRIDGE
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State | CA
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Zip | 91324-1461
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Country | US
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Telephone | 818-486-9496
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YOUNG MEE KIM
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Credential | LAC
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Telephone | 818-809-1009
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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 | LAC 17165
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License Number State | CA
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