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General NPI Number Information
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NPI Number | 1750526547
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Entity Type | Organization
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Legal Business Name | JIN MOON CHIROPRACTIC GROUP, INC.
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Dates
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Enumeration Date | 12/08/2008
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Last Update Date | 07/30/2009
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Provider Practice Location Address
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Address Line | 6888 LINCOLN AVE SUITE C
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City | BUENA PARK
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State | CA
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Zip | 90620-4107
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Country | US
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Telephone | 714-484-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 6888 LINCOLN AVE SUITE C
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City | BUENA PARK
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State | CA
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Zip | 90620-4107
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JIN MOON
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Credential |
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Telephone | 714-484-9000
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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 | DC28135
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License Number State | CA
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