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General NPI Number Information
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NPI Number | 1871866236
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Entity Type | Organization
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Legal Business Name | OLYMPIC W&C CARE CENTER INC
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Dates
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Enumeration Date | 02/15/2012
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Last Update Date | 02/15/2012
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Provider Practice Location Address
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Address Line | 5042 WILSHIRE BLVD 505
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City | LOS ANGELES
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State | CA
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Zip | 90036-4305
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Country | US
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Telephone | 213-505-6534
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Fax | 213-607-3214
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Provider Business Mailing Address
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Address Line | 3109 W OLYMPIC BLVD C
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City | LOS ANGELES
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State | CA
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Zip | 90006-2665
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Country | US
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Telephone | 213-387-2225
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Fax | 213-387-2011
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WOO JIN KIM
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Credential | DC
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Telephone | 714-501-6765
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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