Provider Demographics
NPI:1538657143
Name:KIM, HYUNGJOON (DC)
Entity Type:Individual
Prefix:DR
First Name:HYUNGJOON
Middle Name:
Last Name:KIM
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 1:18886 DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-4606
Mailing Address - Country:US
Mailing Address - Phone:669-300-7736
Mailing Address - Fax:
Practice Address - Street 1:679 HILLTOP DR APT 16
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-3725
Practice Address - Country:US
Practice Address - Phone:669-300-7736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34197111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor