MEDICARE: YONG S KIM ACUPUNCTURE CLINIC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC7719	CA

General Provider Information

NPI Number	:	1144350661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YONG S KIM ACUPUNCTURE CLINIC INC

Provider Business Mailing Address
First Line	:	4160 WILSHIRE BLVD
Second Line	:	SUITE 301
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-3569
Country	:	US
Telephone Number	:	323-933-8814
Fax Number	:	323-933-8815

Provider Business Practice Location Address
First Line	:	4160 WILSHIRE BLVD
Second Line	:	SUITE 301
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-3569
Country	:	US
Telephone Number	:	323-933-8814
Fax Number	:	323-933-8815

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. YONG SEOK KIM
Credential	:	LAC PHD
Telephone Number	:	323-933-8814

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	08/22/2020

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