Healthcare Provider Details

I. General information

NPI: 1437015518
Provider Name (Legal Business Name): CHAEHYONG KIM HAD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/01/2026
Last Update Date: 01/01/2026
Certification Date: 01/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 SKYPARK DR
TORRANCE CA
90505-5313
US

IV. Provider business mailing address

2914 W 8TH ST APT 502
LOS ANGELES CA
90005-1764
US

V. Phone/Fax

Practice location:
  • Phone: 213-215-4474
  • Fax: 213-215-4474
Mailing address:
  • Phone: 213-215-4474
  • Fax: 213-215-4474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA9109
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: