Provider Demographics
NPI:1437396132
Name:PAI, KIWOO (PHD)
Entity Type:Individual
Prefix:DR
First Name:KIWOO
Middle Name:
Last Name:PAI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17502 LAURELBROOK CT
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-8839
Mailing Address - Country:US
Mailing Address - Phone:562-404-0019
Mailing Address - Fax:
Practice Address - Street 1:17502 LAURELBROOK CT
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-8839
Practice Address - Country:US
Practice Address - Phone:562-404-0019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8540171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist