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TAE GON KIM

>> Acupuncturist >> Other Service Providers

Registrant NPI Number: 1538717939

Individual Registrant:
 TAE GON  KIM 
Gender: M
Sole Proprietor

Location and contact information for practice:
5301 WHITTIER BLVD  EAST LOS ANGELES, CA 90022-4038 US
Tel: 323-715-3615  Fax: --

Contact information for business:
2144 CITTADIN DR  FULLERTON, CA 92833-5757 US
Tel: 323-715-3615  Fax: --

Registration Information:
NPI: 1538717939
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171100000XOther Service Providers
Acupuncturist
CAAC15772

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS CA - Page 1



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