Provider Demographics
NPI:1235429879
Name:KIM, SHERRI (DC)
Entity Type:Individual
Prefix:DR
First Name:SHERRI
Middle Name:
Last Name:KIM
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 1:23424 MOBILE ST
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-3323
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17637 SHERMAN WAY STE A
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3575
Practice Address - Country:US
Practice Address - Phone:818-654-7849
Practice Address - Fax:818-654-7548
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-17
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23863111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor