Provider Demographics
NPI:1295390433
Name:OHASHI-KIM, EVELYN (DACM)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:OHASHI-KIM
Suffix:
Gender:F
Credentials:DACM
Other - Prefix:
Other - First Name:AVA
Other - Middle Name:
Other - Last Name:OHASHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DACM
Mailing Address - Street 1:1545 HOTEL CIR S STE 120
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3414
Mailing Address - Country:US
Mailing Address - Phone:619-639-8559
Mailing Address - Fax:619-413-6303
Practice Address - Street 1:1545 HOTEL CIR S STE 120
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3414
Practice Address - Country:US
Practice Address - Phone:619-639-8559
Practice Address - Fax:619-413-6303
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18487171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist