Provider Demographics
NPI:1407168537
Name:AHN, JINHO (DC)
Entity Type:Individual
Prefix:DR
First Name:JINHO
Middle Name:
Last Name:AHN
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 1:412 E DIAMOND AVE
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-3018
Mailing Address - Country:US
Mailing Address - Phone:213-219-1915
Mailing Address - Fax:
Practice Address - Street 1:481 N FREDERICK AVE
Practice Address - Street 2:SUIT 230
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2417
Practice Address - Country:US
Practice Address - Phone:301-527-1510
Practice Address - Fax:301-527-9320
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03601111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor