Provider Demographics
NPI:1396939930
Name:MIN, KYUNG UN (DC)
Entity type:Individual
Prefix:DR
First Name:KYUNG
Middle Name:UN
Last Name:MIN
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 1:17050 CHATSWORTH ST STE 115
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-5888
Mailing Address - Country:US
Mailing Address - Phone:818-832-0897
Mailing Address - Fax:818-832-3076
Practice Address - Street 1:17050 CHATSWORTH ST STE 115
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-5888
Practice Address - Country:US
Practice Address - Phone:818-832-0897
Practice Address - Fax:818-832-3076
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 28006111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor