Provider Demographics
NPI:1467776393
Name:MIN, KAI CHIA KEVIN (OMD, LAC)
Entity Type:Individual
Prefix:MR
First Name:KAI CHIA
Middle Name:KEVIN
Last Name:MIN
Suffix:
Gender:M
Credentials:OMD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3234 MCKINLEY DR.
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051
Mailing Address - Country:US
Mailing Address - Phone:408-888-7960
Mailing Address - Fax:
Practice Address - Street 1:3234 MCKINLEY DR
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-6765
Practice Address - Country:US
Practice Address - Phone:408-929-5108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-22
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist