Provider Demographics
NPI:1366554248
Name:KIM, CHRISTOPHER SUNGBUM (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:SUNGBUM
Last Name:KIM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15424 ASHLEY CT
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-2340
Mailing Address - Country:US
Mailing Address - Phone:714-801-6531
Mailing Address - Fax:
Practice Address - Street 1:5480 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-2238
Practice Address - Country:US
Practice Address - Phone:714-526-9050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30024111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor