Provider Demographics
NPI:1952408817
Name:KIM, JOSEPH BUMSIN (DC, L AC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:BUMSIN
Last Name:KIM
Suffix:
Gender:M
Credentials:DC, L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4128W COMMONWEALTH AVE 101
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-2565
Mailing Address - Country:US
Mailing Address - Phone:714-525-3535
Mailing Address - Fax:714-525-3536
Practice Address - Street 1:4128W COMMONWEALTH AVE 101
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-2565
Practice Address - Country:US
Practice Address - Phone:714-525-3535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11131171100000X
CA29975111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist