MEDICARE: DR HYUN CHUL KIM CHIROPRACTIC 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	111N00000X	Chiropractor	30702	CA

General Provider Information

NPI Number	:	1821302969
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR HYUN CHUL KIM CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	3053 W OLYMPIC BLVD
Second Line	:	203
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2584
Country	:	US
Telephone Number	:	213-384-3830
Fax Number	:	213-384-3662

Provider Business Practice Location Address
First Line	:	3053 W OLYMPIC BLVD
Second Line	:	203
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2584
Country	:	US
Telephone Number	:	213-384-3830
Fax Number	:	213-384-3662

Authorized Official
Title or Position	:	CHIROPRACTIC
Name	:	DR. HYUN CHUL KIM
Credential	:	D.C.
Telephone Number	:	213-384-3830

Provider Enumeration Date	:	07/30/2010
Last Update Date	:	07/30/2010

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