Provider Demographics
NPI:1295903458
Name:KIM, HYUN GI (AC)
Entity type:Individual
Prefix:
First Name:HYUN
Middle Name:GI
Last Name:KIM
Suffix:
Gender:M
Credentials:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 S LA FAYETTE PARK PL
Mailing Address - Street 2:#109
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-4639
Mailing Address - Country:US
Mailing Address - Phone:213-268-9444
Mailing Address - Fax:
Practice Address - Street 1:323 S LA FAYETTE PARK PL
Practice Address - Street 2:#109
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-4639
Practice Address - Country:US
Practice Address - Phone:213-268-9444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5630171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist