Provider Demographics
NPI:1366580847
Name:KIM, HAEJUNG HELEN (LAC)
Entity type:Individual
Prefix:MRS
First Name:HAEJUNG
Middle Name:HELEN
Last Name:KIM
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13519 HUBBARD ST
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-4419
Mailing Address - Country:US
Mailing Address - Phone:818-833-5977
Mailing Address - Fax:818-833-5787
Practice Address - Street 1:13519 HUBBARD ST
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-4419
Practice Address - Country:US
Practice Address - Phone:818-833-5977
Practice Address - Fax:818-833-5787
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8448171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist