Provider Demographics
NPI:1114225539
Name:HUISOON KIM PROFESSIONAL
Entity Type:Organization
Organization Name:HUISOON KIM PROFESSIONAL
Other - Org Name:KIMS ACUPUNCTURE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HUISOON
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DAC
Authorized Official - Phone:661-831-2400
Mailing Address - Street 1:1619 S H ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-4931
Mailing Address - Country:US
Mailing Address - Phone:661-831-2400
Mailing Address - Fax:661-831-2430
Practice Address - Street 1:1619 S H ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-4931
Practice Address - Country:US
Practice Address - Phone:661-831-2400
Practice Address - Fax:661-831-2430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 9661261QH0100X
CAAC 13644261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service