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General NPI Number Information
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NPI Number | 1952481020
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Entity Type | Individual
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Provider Name | SPENCER WOO KIM ACUPUNCTURIST
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Gender | Male
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 10/13/2011
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Provider Practice Location Address
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Address Line | 3440 WILSHIRE BLVD SUITE #280
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City | LOS ANGELES
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State | CA
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Zip | 90010-2101
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Country | US
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Telephone | 213-884-2090
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Fax | 213-221-4719
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Provider Business Mailing Address
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Address Line | 375 E 2ND ST #307
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City | LOS ANGELES
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State | CA
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Zip | 90012-4239
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Country | US
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Telephone | 213-884-2090
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Fax | 213-221-4719
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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 | AC7994
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License Number State | CA
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