Provider Demographics
NPI:1023222544
Name:JIN-KIM, SENGHEE (LAC)
Entity Type:Individual
Prefix:DR
First Name:SENGHEE
Middle Name:
Last Name:JIN-KIM
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2334 W VALENCIA DR
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-3128
Mailing Address - Country:US
Mailing Address - Phone:714-626-0003
Mailing Address - Fax:714-626-0304
Practice Address - Street 1:2334 W VALENCIA DR
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-3128
Practice Address - Country:US
Practice Address - Phone:714-626-0003
Practice Address - Fax:714-626-0304
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9513171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist