Provider Demographics
NPI:1326093931
Name:KIM, YOUNG HOON (LAC PHD)
Entity Type:Individual
Prefix:MR
First Name:YOUNG
Middle Name:HOON
Last Name:KIM
Suffix:
Gender:M
Credentials:LAC PHD
Other - Prefix:
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Mailing Address - Street 1:15508 S NORMANDIE AVE
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247
Mailing Address - Country:US
Mailing Address - Phone:310-523-3747
Mailing Address - Fax:310-323-6470
Practice Address - Street 1:15508 S NORMANDIE AVE
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247
Practice Address - Country:US
Practice Address - Phone:310-523-3747
Practice Address - Fax:310-323-6470
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC6544171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist