Provider Demographics
NPI:1033286448
Name:INJURY CARE CLINIC INC
Entity Type:Organization
Organization Name:INJURY CARE CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:808-591-8000
Mailing Address - Street 1:1221 KAPIOLANI BLVD
Mailing Address - Street 2:#6 G
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814
Mailing Address - Country:US
Mailing Address - Phone:808-591-8000
Mailing Address - Fax:808-591-2625
Practice Address - Street 1:1221 KAPIOLANI BLVD
Practice Address - Street 2:#6 G
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814
Practice Address - Country:US
Practice Address - Phone:808-591-8000
Practice Address - Fax:808-591-2625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC757111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI56530Medicare ID - Type Unspecified