MEDICARE: BOKYOUNG SIM DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	35044	CA

General Provider Information

NPI Number	:	1053997288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BOKYOUNG SIM DC

Provider Business Mailing Address
First Line	:	3832 WILSHIRE BLVD STE 103
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-3220
Country	:	US
Telephone Number	:	323-381-8848
Fax Number	:

Provider Business Practice Location Address
First Line	:	3832 WILSHIRE BLVD STE 103
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-3220
Country	:	US
Telephone Number	:	213-388-8820
Fax Number	:	213-529-4086

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2021
Last Update Date	:	03/18/2021

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Directions to “ BOKYOUNG SIM DC” Practice Location

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