=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932845187
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ACUKT CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/10/2022
-----------------------------------------------------
Last Update Date | 05/10/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3030 W OLYMPIC BLVD STE 211
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90006-6509
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-703-6939
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3030 W OLYMPIC BLVD STE 211
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90006-6509
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-703-6939
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | KITAK KIM
-----------------------------------------------------
Credential | L.AC
-----------------------------------------------------
Telephone | 213-703-6939
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------