Provider Demographics
NPI:1609822857
Name:KIM, SEONHOON SEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:SEONHOON
Middle Name:SEAN
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 1:9240 GARDEN GROVE BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-1400
Mailing Address - Country:US
Mailing Address - Phone:714-610-7575
Mailing Address - Fax:714-534-2994
Practice Address - Street 1:9240 GARDEN GROVE BLVD STE 2
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-1400
Practice Address - Country:US
Practice Address - Phone:714-610-7575
Practice Address - Fax:714-534-2994
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29494111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor