Provider Demographics
NPI:1447493523
Name:KIM, YOUNGHUN (LAC)
Entity type:Individual
Prefix:
First Name:YOUNGHUN
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6552 BOLSA AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-2656
Mailing Address - Country:US
Mailing Address - Phone:714-894-1313
Mailing Address - Fax:714-894-1616
Practice Address - Street 1:6552 BOLSA AVE
Practice Address - Street 2:SUITE G
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-2656
Practice Address - Country:US
Practice Address - Phone:714-894-1313
Practice Address - Fax:714-894-1616
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC11408171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist