Provider Demographics
NPI:1033240940
Name:KIM, HOON (ACUPUNCTURIST)
Entity Type:Individual
Prefix:MR
First Name:HOON
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7851 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-2422
Mailing Address - Country:US
Mailing Address - Phone:714-249-0532
Mailing Address - Fax:
Practice Address - Street 1:7851 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-2422
Practice Address - Country:US
Practice Address - Phone:714-249-0532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2010-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5660171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist