Provider Demographics
NPI:1225343106
Name:KIM, SUNNY SUNEUI (L AC)
Entity Type:Individual
Prefix:MRS
First Name:SUNNY
Middle Name:SUNEUI
Last Name:KIM
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 CRENSHAW BLVD
Mailing Address - Street 2:#105
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-1964
Mailing Address - Country:US
Mailing Address - Phone:310-460-8197
Mailing Address - Fax:
Practice Address - Street 1:903 CRENSHAW BLVD
Practice Address - Street 2:#105
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019
Practice Address - Country:US
Practice Address - Phone:310-460-8197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6231171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist