Healthcare Provider Details

I. General information

NPI: 1619802238
Provider Name (Legal Business Name): CHAE HYONG KIM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 W 6TH ST STE 302
LOS ANGELES CA
90020-1521
US

IV. Provider business mailing address

3000 W 6TH ST STE 302
LOS ANGELES CA
90020-1521
US

V. Phone/Fax

Practice location:
  • Phone: 213-973-0045
  • Fax: 213-257-8657
Mailing address:
  • Phone: 213-973-0045
  • Fax: 213-257-8657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: MR. CHAE HYONG KIM
Title or Position: OWNER
Credential: HIS
Phone: 213-973-0045