Provider Demographics
NPI:1851528780
Name:KIM, HYUNG WOO (LAC)
Entity Type:Individual
Prefix:
First Name:HYUNG WOO
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:1300 W GONZALES RD
Mailing Address - Street 2:#105
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-3061
Mailing Address - Country:US
Mailing Address - Phone:805-263-3713
Mailing Address - Fax:805-988-9709
Practice Address - Street 1:1300 W GONZALES RD
Practice Address - Street 2:#105
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-3061
Practice Address - Country:US
Practice Address - Phone:805-263-3713
Practice Address - Fax:805-988-9709
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAAC10264171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist