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General NPI Number Information
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NPI Number | 1720544703
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Entity Type | Individual
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Provider Name | OLIVIA AHHEE KIM
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Gender | Female
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Dates
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Enumeration Date | 02/14/2019
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Last Update Date | 02/14/2019
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Provider Practice Location Address
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Address Line | 3944 WILSHIRE BLVD # 2-1
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City | LOS ANGELES
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State | CA
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Zip | 90010-3303
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Country | US
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Telephone | 213-924-3319
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Fax |
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Provider Business Mailing Address
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Address Line | 605 ALBERTA ST
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City | ALTADENA
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State | CA
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Zip | 91001-5416
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Country | US
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Telephone |
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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 | AC9929
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License Number State | CA
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