Provider Demographics
NPI:1972954014
Name:KIM, YOUNG M (LAC)
Entity Type:Individual
Prefix:
First Name:YOUNG
Middle Name:M
Last Name:KIM
Suffix:
Gender:F
Credentials:LAC
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Mailing Address - Street 1:18500 MAYALL ST
Mailing Address - Street 2:H
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-1461
Mailing Address - Country:US
Mailing Address - Phone:818-486-9496
Mailing Address - Fax:
Practice Address - Street 1:16250 VENTURA BLVD
Practice Address - Street 2:STE 450
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2204
Practice Address - Country:US
Practice Address - Phone:818-809-1009
Practice Address - Fax:818-809-1009
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2017-04-15
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist