Individual
DR. CHANG K KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.AC., O.M.D., PH D.
Contact information
Practice address
326 RESERVATION RD, SUITE E, MARINA, CA 93933-3257
(831) 384-2313
(831) 384-2314
Mailing address
326 RESERVATION RD, SUITE E, MARINA, CA 93933-3257
(831) 384-2313
(831) 384-2314
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC 1513
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC 1513
CA MEDICAL LICENSE
CA
Enumeration date
10/31/2007
Last updated
10/31/2007
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