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NPI Code Detail

MEDICARE: DR. BYUNG KWON CHA D.C.

MEDICARE:  DR. BYUNG KWON  CHA  D.C.
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
1111N00000XChiropractorDC3927MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669565560
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BYUNG KWON CHA D.C.
Provider Business Mailing Address
First Line : 1401 SILVER LAKE RD NW
Second Line : SUITE 4
City : NEW BRIGHTON
State : MN
Zip : 55112-9307
Country : US
Telephone Number : 651-631-0093
Fax Number : 651-631-9699
Provider Business Practice Location Address
First Line : 1401 SILVER LAKE RD NW
Second Line : SUITE 4
City : NEW BRIGHTON
State : MN
Zip : 55112-9307
Country : US
Telephone Number : 651-631-0093
Fax Number : 651-631-9699
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 10/15/2011

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Directions to “ DR. BYUNG KWON CHA D.C.” Practice Location

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