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General NPI Number Information
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NPI Number | 1972273555
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Entity Type | Individual
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Provider Name | MIN JOONG KIM
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Gender | Male
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Dates
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Enumeration Date | 09/15/2021
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Last Update Date | 09/16/2023
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Provider Practice Location Address
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Address Line | 910 HALE PL STE 214
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City | CHULA VISTA
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State | CA
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Zip | 91914-3504
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Country | US
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Telephone | 619-922-2902
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Fax |
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Provider Business Mailing Address
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Address Line | 2227 OLD BARN LN
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City | CHULA VISTA
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State | CA
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Zip | 91915-1946
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Country | US
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Telephone | 619-977-7354
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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 | 19242
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License Number State | CA
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