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General NPI Number Information
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NPI Number | 1124241526
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Entity Type | Organization
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Legal Business Name | GOHL & KIM CHIROPRACTIC, INC
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 05/07/2015
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Provider Practice Location Address
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Address Line | 1111 N BRAND BLVD # 402
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City | GLENDALE
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State | CA
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Zip | 91202-3070
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Country | US
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Telephone | 818-243-6206
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Fax | 818-243-2908
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Provider Business Mailing Address
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Address Line | 1111 N BRAND BLVD # 402
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City | GLENDALE
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State | CA
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Zip | 91202-3070
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Country | US
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Telephone | 818-243-6206
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Fax | 818-243-2908
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Authorized Official
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Title or Position | MEMBER
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Name | DR. DONG KIM
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Credential | D.C.
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Telephone | 808-944-1117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC 26564
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License Number State | CA
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