Provider Demographics
NPI:1003082900
Name:KROMAS, KIM D (DC)
Entity Type:Individual
Prefix:MS
First Name:KIM
Middle Name:D
Last Name:KROMAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 W 5TH ST
Mailing Address - Street 2:#101
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-2700
Mailing Address - Country:US
Mailing Address - Phone:310-832-5818
Mailing Address - Fax:310-832-7236
Practice Address - Street 1:302 W 5TH ST
Practice Address - Street 2:#101
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-2700
Practice Address - Country:US
Practice Address - Phone:310-832-5818
Practice Address - Fax:310-832-7236
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC17731111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor