Provider Demographics
NPI:1225465008
Name:SANG EON KIM CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:SANG EON KIM CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SANG
Authorized Official - Middle Name:EON
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:408-720-8892
Mailing Address - Street 1:693 E REMINGTON DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-1977
Mailing Address - Country:US
Mailing Address - Phone:408-720-8892
Mailing Address - Fax:408-720-8298
Practice Address - Street 1:693 E REMINGTON DR
Practice Address - Street 2:SUITE A
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-1977
Practice Address - Country:US
Practice Address - Phone:408-720-8892
Practice Address - Fax:408-720-8298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-10
Last Update Date:2017-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30142111N00000X
CAAC17256171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty