Provider Demographics
NPI:1558544080
Name:KIM, BYUM SUK (DC)
Entity Type:Individual
Prefix:
First Name:BYUM
Middle Name:SUK
Last Name:KIM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:SUK
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:3240 WILSHIRE BL
Mailing Address - Street 2:#240
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010
Mailing Address - Country:US
Mailing Address - Phone:213-365-0212
Mailing Address - Fax:213-365-0480
Practice Address - Street 1:3240 WILSHIRE BL
Practice Address - Street 2:#240
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010
Practice Address - Country:US
Practice Address - Phone:213-365-0212
Practice Address - Fax:213-365-0480
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-06
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30749111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
11901787OtherCAQH