Active NPI
Jennie Kim
- Chiropractor
- Los Angeles, CA
National Provider Identifier
1255739090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC29477
- Practice address
- 3055 Wilshire Blvd Ste 100
Los Angeles, CA 90010-1119 - Phone
- (213) 383-0008
- NPI assigned
- Dec 10, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC29477 | CA | Primary |
Addresses
Primary practice location
3055 Wilshire Blvd Ste 100
Los Angeles, CA 90010-1119
Mailing address
3055 Wilshire Blvd Ste 100
Los Angeles, CA 90010-1119
Phone (213) 383-0008
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC29477 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418169600000",
"number": "1255739090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3055 WILSHIRE BLVD STE 100",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900101119",
"telephone_number": "213-383-0008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3055 WILSHIRE BLVD STE 100",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900101119",
"telephone_number": "213-383-0008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JENNIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-10",
"last_updated": "2014-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC29477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.