Provider Demographics
NPI:1245592518
Name:KIM, JUNG S (DAOM)
Entity Type:Individual
Prefix:DR
First Name:JUNG
Middle Name:S
Last Name:KIM
Suffix:
Gender:M
Credentials:DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1674 POST ST STE 3
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3682
Mailing Address - Country:US
Mailing Address - Phone:415-361-0607
Mailing Address - Fax:
Practice Address - Street 1:1674 POST ST STE 3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3682
Practice Address - Country:US
Practice Address - Phone:415-361-0607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6849171100000X
CAAC6849171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist