Provider Demographics
NPI:1205190410
Name:KIM, HYUN JUNG (LAC)
Entity Type:Individual
Prefix:MRS
First Name:HYUN JUNG
Middle Name:
Last Name: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 1:10440 PARAMOUNT BLVD
Mailing Address - Street 2:D236
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-2356
Mailing Address - Country:US
Mailing Address - Phone:213-769-6000
Mailing Address - Fax:
Practice Address - Street 1:10440 PARAMOUNT BLVD
Practice Address - Street 2:D236
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-2356
Practice Address - Country:US
Practice Address - Phone:213-769-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14706171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist