MEDICARE: MR. KWANG HUN KIM ACUPUNCTURIST

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	AC11537	CA

General Provider Information

NPI Number	:	1366562639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KWANG HUN KIM ACUPUNCTURIST

Provider Business Mailing Address
First Line	:	3500 W 6TH ST STE 316
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-5805
Country	:	US
Telephone Number	:	213-908-6257
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 W 6TH ST STE 316
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-5805
Country	:	US
Telephone Number	:	213-908-6257
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	04/12/2024

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