Provider Demographics
NPI:1073904892
Name:KIM, DAVID YOUNG (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:YOUNG
Last Name:KIM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3250 COUNTRY CLUB DRIVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-3602
Mailing Address - Country:US
Mailing Address - Phone:323-643-4337
Mailing Address - Fax:323-373-1612
Practice Address - Street 1:1144 S WESTERN AVE
Practice Address - Street 2:#202
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2379
Practice Address - Country:US
Practice Address - Phone:323-643-4337
Practice Address - Fax:323-643-4337
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22740111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor