Provider Demographics
NPI:1447597208
Name:J.J.KIM ACUPUNCTURE CLINIC PC
Entity Type:Organization
Organization Name:J.J.KIM ACUPUNCTURE CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONG
Authorized Official - Middle Name:JOUNG
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, PHD
Authorized Official - Phone:714-833-4077
Mailing Address - Street 1:1966 E CHAPMAN AVE
Mailing Address - Street 2:SUITE J
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-4142
Mailing Address - Country:US
Mailing Address - Phone:714-833-4077
Mailing Address - Fax:714-871-8882
Practice Address - Street 1:1966 E CHAPMAN AVE
Practice Address - Street 2:SUITE J
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-4142
Practice Address - Country:US
Practice Address - Phone:714-833-4077
Practice Address - Fax:714-871-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-12
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14047171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty