Provider Demographics
NPI:1427829290
Name:KIM, JUNE (ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:KIM
Suffix:
Gender:
Credentials:ACUPUNCTURIST
Other - Prefix:MR
Other - First Name:JUNE
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ACUPUNCTURIST
Mailing Address - Street 1:910 S WILTON PL APT 1
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-2128
Mailing Address - Country:US
Mailing Address - Phone:213-322-9710
Mailing Address - Fax:
Practice Address - Street 1:22640 GOLDEN SPRINGS DR STE B
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-2200
Practice Address - Country:US
Practice Address - Phone:213-518-4635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC19630171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist