Provider Demographics
NPI:1083965263
Name:HEALING ACUPUNCTURE
Entity Type:Organization
Organization Name:HEALING ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KYUNG
Authorized Official - Middle Name:SIK
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, MS
Authorized Official - Phone:510-386-2071
Mailing Address - Street 1:3150 SOUTHWYCKE TER
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-1960
Mailing Address - Country:US
Mailing Address - Phone:510-386-2071
Mailing Address - Fax:510-797-1157
Practice Address - Street 1:37553 FREMONT BLVD
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-3706
Practice Address - Country:US
Practice Address - Phone:510-386-2071
Practice Address - Fax:510-797-1157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12534171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1902139934OtherNPI FOR INDIVIDUAL