Provider Demographics
NPI:1285883546
Name:KIM, KAY KYUNG-HWA (L AC)
Entity type:Individual
Prefix:MS
First Name:KAY
Middle Name:KYUNG-HWA
Last Name:KIM
Suffix:
Gender:F
Credentials:L AC
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Mailing Address - Street 1:1818 S. WESTERN AVE
Mailing Address - Street 2:C/O REVIVAL HEALTH CENTER, SUITE #302
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-5862
Mailing Address - Country:US
Mailing Address - Phone:323-737-3000
Mailing Address - Fax:323-737-3363
Practice Address - Street 1:1818 S. WESTERN AVE
Practice Address - Street 2:C/O REVIVAL HEALTH CENTER, SUITE #302
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-5862
Practice Address - Country:US
Practice Address - Phone:323-737-3000
Practice Address - Fax:323-737-3363
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAAC12187171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist