Provider Demographics
NPI:1982193355
Name:YANGDONG KIM CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:YANGDONG KIM CHIROPRACTIC INC.
Other - Org Name:NEUROBALANCE CHIROPRACTIC & ACUPUNCTURE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YANGDONG
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DAOM, LAC
Authorized Official - Phone:714-296-2905
Mailing Address - Street 1:4200 CHINO HILLS PKWY STE 900
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-3784
Mailing Address - Country:US
Mailing Address - Phone:714-296-2905
Mailing Address - Fax:
Practice Address - Street 1:4200 CHINO HILLS PKWY STE 900
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-3784
Practice Address - Country:US
Practice Address - Phone:714-296-2905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-01
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32153111N00000X
CA14488171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty