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General NPI Number Information
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NPI Number | 1477595155
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Entity Type | Individual
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Provider Name | MOON YOUNG IM VI D.C.
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Gender | Female
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 12/23/2014
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Provider Practice Location Address
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Address Line | 2655 W OLYMPIC BLVD SUITE 101
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City | LOS ANGELES
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State | CA
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Zip | 90006-2800
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Country | US
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Telephone | 213-383-0007
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Fax | 866-621-2931
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Provider Business Mailing Address
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Address Line | 2655 W OLYMPIC BLVD SUITE 101
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City | LOS ANGELES
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State | CA
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Zip | 90006-2800
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Country | US
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Telephone | 213-383-0007
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Fax | 866-621-2931
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DC29405
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License Number State | CA
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