Provider Demographics
NPI:1669687232
Name:KIM, KAY J (AC)
Entity Type:Individual
Prefix:DR
First Name:KAY
Middle Name:J
Last Name:KIM
Suffix:
Gender:F
Credentials:AC
Other - Prefix:
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Mailing Address - Street 1:246 LOMBARD ST # A
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-8219
Mailing Address - Country:US
Mailing Address - Phone:805-496-6977
Mailing Address - Fax:805-496-7499
Practice Address - Street 1:246 LOMBARD ST # A
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-8219
Practice Address - Country:US
Practice Address - Phone:805-496-6977
Practice Address - Fax:805-496-7499
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9997171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist