Provider Demographics
NPI:1457598948
Name:KIM, ESTHER YELIM (LAC)
Entity Type:Individual
Prefix:DR
First Name:ESTHER
Middle Name:YELIM
Last Name:KIM
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 E. THOUSAND OAKS BLVD
Mailing Address - Street 2:CHAN ACUPUNCTURE CLINIC
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360
Mailing Address - Country:US
Mailing Address - Phone:425-463-6187
Mailing Address - Fax:805-497-7631
Practice Address - Street 1:650 E. THOUSAND OAKS BLVD
Practice Address - Street 2:CHAN ACUPUNCTURE CLINIC
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-6009
Practice Address - Country:US
Practice Address - Phone:425-463-6187
Practice Address - Fax:805-497-7631
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 13424171100000X
WAAC 60055629171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist