Provider Demographics
NPI:1245201888
Name:KIM, JHAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JHAN
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 1:921 W CHELTENHAM AVE
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-3208
Mailing Address - Country:US
Mailing Address - Phone:215-782-1235
Mailing Address - Fax:215-782-1239
Practice Address - Street 1:7301 MOUNTAIN AVENUE
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027
Practice Address - Country:US
Practice Address - Phone:215-782-1237
Practice Address - Fax:215-782-1239
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2355361000OtherIBC
PA2355361000OtherIBC