Provider Demographics
NPI:1831385723
Name:KIM, NORA HYOSHIN (LAC)
Entity type:Individual
Prefix:MS
First Name:NORA
Middle Name:HYOSHIN
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 1:1142 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-5232
Mailing Address - Country:US
Mailing Address - Phone:408-429-4659
Mailing Address - Fax:408-297-7033
Practice Address - Street 1:1314 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-3012
Practice Address - Country:US
Practice Address - Phone:408-429-4659
Practice Address - Fax:408-297-7033
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10763171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist