Individual ProviderTaehyang KimAcupuncturistOther Service ProvidersPractice Address18062 Irvine Blvd Ste 100, Tustin, CA 92780-3328(949) 812-9457PECOS EnrollmentBased on the most recent information from CMS, provider Taehyang Kim does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1174828578Provider TypeIndividualFull NameKim, TaehyangCredentialLA.CGenderFemaleSole ProprietorYesEnumeration Date1/14/2011Last Updated1/14/2011Contact InformationPractice LocationPractice Address18062 Irvine Blvd Ste 100, Tustin, CA 92780-3328Phone(949) 812-9457FaxUnlisted FaxMailing LocationMailing Address18062 Irvine Blvd Ste 100, Tustin, CA 92780-3328Phone(949) 812-9457FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171100000XPrimaryDescriptionAcupuncturistOther Service ProvidersLicense13814CaliforniaProvider IdentifiersIDDescriptionIssuerID13814DescriptionOtherIssuerACUPUNCTURE BOARDCalifornia