Provider Demographics
NPI:1326482100
Name:HORNING, KIM
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:HORNING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KIM
Other - Middle Name:
Other - Last Name:HORNING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:8410 NENTRA ST
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-2713
Mailing Address - Country:US
Mailing Address - Phone:619-504-9990
Mailing Address - Fax:
Practice Address - Street 1:2537 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-2807
Practice Address - Country:US
Practice Address - Phone:619-358-9508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2020-04-08
Deactivation Date:2013-08-23
Deactivation Code:
Reactivation Date:2020-04-08
Provider Licenses
StateLicense IDTaxonomies
CA14764171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist