Provider Demographics
NPI:1699045815
Name:KIM, BRENDEN JAMES (DC, MS)
Entity Type:Individual
Prefix:DR
First Name:BRENDEN
Middle Name:JAMES
Last Name:KIM
Suffix:
Gender:M
Credentials:DC, MS
Other - Prefix:DR
Other - First Name:BRENDEN
Other - Middle Name:JAMES
Other - Last Name:LEOMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC, MS
Mailing Address - Street 1:98-027 HEKAHA ST
Mailing Address - Street 2:UNIT 17
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4910
Mailing Address - Country:US
Mailing Address - Phone:808-487-2273
Mailing Address - Fax:877-227-0801
Practice Address - Street 1:98-027 HEKAHA ST
Practice Address - Street 2:UNIT 17
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4910
Practice Address - Country:US
Practice Address - Phone:808-487-2273
Practice Address - Fax:808-356-0337
Is Sole Proprietor?:No
Enumeration Date:2012-01-04
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDC-1222111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIFV634ZMedicare PIN