MEDICARE: WOO S KIM CHIROPRACTIC REHAB THERAPY A PROF CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC27464	CA

General Provider Information

NPI Number	:	1003130550
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOO S KIM CHIROPRACTIC REHAB THERAPY A PROF CORP

Provider Business Mailing Address
First Line	:	2120 W 8TH ST STE 200
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-4082
Country	:	US
Telephone Number	:	213-483-3987
Fax Number	:	213-483-5547

Provider Business Practice Location Address
First Line	:	2120 W 8TH ST STE 200
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-4082
Country	:	US
Telephone Number	:	213-483-3987
Fax Number	:	213-483-5547

Authorized Official
Title or Position	:	CEO
Name	:	DR. WOO S KIM
Credential	:	DC
Telephone Number	:	213-483-3987

Provider Enumeration Date	:	03/25/2010
Last Update Date	:	09/28/2010

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