MEDICARE: BK ACUHEALTH, 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	13432	CA

General Provider Information

NPI Number	:	1609326370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BK ACUHEALTH, INC.

Provider Business Mailing Address
First Line	:	18750 COLIMA RD STE D
Second Line	:
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748-2962
Country	:	US
Telephone Number	:	714-340-7833
Fax Number	:	714-727-0158

Provider Business Practice Location Address
First Line	:	18750 COLIMA RD STE D
Second Line	:
City	:	ROWLAND HEIGHTS
State	:	CA
Zip	:	91748-2962
Country	:	US
Telephone Number	:	714-340-7833
Fax Number	:	714-727-0158

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	JINWON KIM
Credential	:	L.AC
Telephone Number	:	714-340-7833

Provider Enumeration Date	:	10/06/2016
Last Update Date	:	10/06/2016

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