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General NPI Number Information
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NPI Number | 1982193355
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Entity Type | Organization
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Legal Business Name | YANGDONG KIM CHIROPRACTIC INC.
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Dates
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Enumeration Date | 05/01/2018
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Last Update Date | 05/01/2018
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Provider Practice Location Address
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Address Line | 4200 CHINO HILLS PKWY STE 900
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City | CHINO HILLS
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State | CA
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Zip | 91709-3784
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Country | US
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Telephone | 714-296-2905
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 CHINO HILLS PKWY STE 900
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City | CHINO HILLS
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State | CA
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Zip | 91709-3784
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Country | US
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Telephone | 714-296-2905
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YANGDONG KIM
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Credential | DC., DAOM., LAC.
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Telephone | 714-296-2905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 14488
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 32153
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License Number State | CA
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