Provider Demographics
NPI:1033361399
Name:HONG, KEVIN SUK BUEM (DC)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:SUK BUEM
Last Name:HONG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 W OLYMPIC BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2640
Mailing Address - Country:US
Mailing Address - Phone:213-365-1400
Mailing Address - Fax:213-365-1401
Practice Address - Street 1:2727 W.OYMPIC BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2637
Practice Address - Country:US
Practice Address - Phone:213-365-1400
Practice Address - Fax:213-365-1401
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31042111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor