Provider Demographics
NPI:1528698131
Name:GILEAD ACUPUNCTURE INC. DBA KIM'S ACUPUNCTURE
Entity type:Organization
Organization Name:GILEAD ACUPUNCTURE INC. DBA KIM'S ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:CHUL UN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:213-718-2115
Mailing Address - Street 1:1256 BOYNTON ST APT 16
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-3441
Mailing Address - Country:US
Mailing Address - Phone:213-718-2115
Mailing Address - Fax:
Practice Address - Street 1:711 S VERMONT AVE STE 113
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-1587
Practice Address - Country:US
Practice Address - Phone:213-718-2115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty