Provider Demographics
NPI:1225200561
Name:KIM, MU SUNG (ACUPUNCTURE)
Entity type:Individual
Prefix:
First Name:MU SUNG
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:ACUPUNCTURE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5797 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-2044
Mailing Address - Country:US
Mailing Address - Phone:714-522-6200
Mailing Address - Fax:714-522-6201
Practice Address - Street 1:5797 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-2044
Practice Address - Country:US
Practice Address - Phone:714-522-6200
Practice Address - Fax:714-522-6201
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12000171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist