Provider Demographics
NPI:1497060503
Name:AN, CHRISTINE JINKYOUNG (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:JINKYOUNG
Last Name:AN
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 1:955 S WESTERN AVE
Mailing Address - Street 2:#203
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-1006
Mailing Address - Country:US
Mailing Address - Phone:323-735-2225
Mailing Address - Fax:323-735-1194
Practice Address - Street 1:955 S. WESTERN AVE.
Practice Address - Street 2:#203
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006
Practice Address - Country:US
Practice Address - Phone:323-735-2225
Practice Address - Fax:323-735-1194
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23729111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner