Provider Demographics
NPI:1184869109
Name:KIM, HYUN CHUL (DC)
Entity type:Individual
Prefix:DR
First Name:HYUN CHUL
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:3053 W OLYMPIC BLVD
Mailing Address - Street 2:203
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2584
Mailing Address - Country:US
Mailing Address - Phone:213-384-3830
Mailing Address - Fax:
Practice Address - Street 1:3053 W OLYMPIC BLVD
Practice Address - Street 2:203
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2584
Practice Address - Country:US
Practice Address - Phone:213-384-3830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-04
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30702111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor