Individual provider Active NPI

Kyung Un Min, D.C.

  • Chiropractor
  • Granada Hills, CA
National Provider Identifier
1396939930
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 28006 Issued in CA
Practice address
17050 Chatsworth St Ste 115
Granada Hills, CA 91344-5888
Phone
(818) 832-0897
Fax
(818) 832-3076
NPI assigned
Aug 28, 2007
Last updated
Aug 28, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 28006 CA Primary

Addresses

Primary practice location

17050 Chatsworth St Ste 115
Granada Hills, CA 91344-5888

Mailing address

17050 Chatsworth St Ste 115
Granada Hills, CA 91344-5888
Phone (818) 832-0897

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060201000814 CA Practitioner - Chiropractic 6800800574 Practice locations: Los Angeles, CA; Granada Hills, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17050 Chatsworth St
Suite 115
Granada Hills, CA 91344-5888
Phone (818) 832-0897

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 28006CAMDChiropractor
28006CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Union Roh Chiropractic Group Inc Chiropractor Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1396939930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17050 CHATSWORTH ST STE 115",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913445888",
            "telephone_number": "818-832-0897",
            "fax_number": "818-832-3076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17050 CHATSWORTH ST STE 115",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913445888",
            "telephone_number": "818-832-0897",
            "fax_number": "818-832-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIN",
        "first_name": "KYUNG",
        "middle_name": "UN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 28006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granada Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.