MEDICARE: KDJ HEALTHCARE INC

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	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	58812	OTHER	CA	CA BOARD OF PHARMACY

General Provider Information

NPI Number	:	1336260348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KDJ HEALTHCARE INC

Provider Business Mailing Address
First Line	:	2781-2783 W. OLYMPIC BLVD.
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2632
Country	:	US
Telephone Number	:	213-816-0270
Fax Number	:	213-816-0271

Provider Business Practice Location Address
First Line	:	2781-2783 W. OLYMPIC BLVD.
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2632
Country	:	US
Telephone Number	:	213-816-0270
Fax Number	:	213-816-0271

Authorized Official
Title or Position	:	CEO
Name	:	OLIVIA THAI
Credential	:
Telephone Number	:	213-816-0270

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	12/27/2022

Similar Medicare Providers

1063957439 — SEO ACUPUNCTURE & HERB CLINIC, INC.
Practice Location Address:

2775 W OLYMPIC BLVD
LOS ANGELES, CA
90006-2632

Practice Phone: 213-822-2330
Practice Fax:

1518713585 — KDJ HEALTHCARE INC
Practice Location Address:

2781 W OLYMPIC BLVD
LOS ANGELES, CA
90006-2632

Practice Phone: 213-816-0270
Practice Fax: 213-816-0721

1811864226 — LEANNA DAYOUNG KIM
Practice Location Address:

2781 W OLYMPIC BLVD
LOS ANGELES, CA
90006-2632

Practice Phone: 213-816-0270
Practice Fax:

1669507851 — GRACE KIM
Practice Location Address:

3600 WILSHIRE BLVD STE 2200
LOS ANGELES, CA
90010-2632

Practice Phone: 213-382-4400
Practice Fax:

1366639924 — DENISE MARSHALL
Practice Location Address:

8346 BEVERLY BLVD
LOS ANGELES, CA
90048-2632

Practice Phone: 323-653-1677
Practice Fax:

1992992564 — STEPHANIE CHISM
Practice Location Address:

8346 BEVERLY BLVD
LOS ANGELES, CA
90048-2632

Practice Phone: 323-659-1677
Practice Fax:

Directions to “KDJ HEALTHCARE INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.