MEDICARE: HYUNGSOO KIM D.C

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	35051	CA

General Provider Information

NPI Number	:	1336429398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HYUNGSOO KIM D.C

Provider Business Mailing Address
First Line	:	2970 W OLYMPIC BLVD STE 303
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2518
Country	:	US
Telephone Number	:	213-388-4030
Fax Number	:	213-388-4034

Provider Business Practice Location Address
First Line	:	2970 W OLYMPIC BLVD STE 303
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2518
Country	:	US
Telephone Number	:	213-388-4030
Fax Number	:	213-388-4034

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2011
Last Update Date	:	04/26/2021

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Directions to “ HYUNGSOO KIM D.C” Practice Location

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