Provider Demographics
NPI:1932350360
Name:KIM, SALLIE HEHSEON (AC)
Entity Type:Individual
Prefix:MS
First Name:SALLIE
Middle Name:HEHSEON
Last Name:KIM
Suffix:
Gender:F
Credentials:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7205 GREENLEAF AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-1317
Mailing Address - Country:US
Mailing Address - Phone:562-945-8873
Mailing Address - Fax:562-945-4324
Practice Address - Street 1:7205 GREENLEAF AVE
Practice Address - Street 2:SUITE B
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-1317
Practice Address - Country:US
Practice Address - Phone:562-945-8873
Practice Address - Fax:562-945-4324
Is Sole Proprietor?:No
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3362171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist