Active NPI
Phillip Jung-Wan Kim, D.C.
- Chiropractor
- Los Angeles, CA
National Provider Identifier
1427376672
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective May 20, 2014.
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 24057
- Practice address
- 3434 W 6TH St Ste 312
Los Angeles, CA 90020-2578 - Phone
- (213) 388-4556
- Fax
- (213) 388-4557
- NPI assigned
- May 12, 2010
- Sex
- Male
- 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 | 24057 | CA | Primary |
Addresses
Primary practice location
3434 W 6TH St Ste 312
Los Angeles, CA 90020-2578
Mailing address
3434 W 6TH St Ste 312
Los Angeles, CA 90020-2578
Phone (213) 388-4556
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24057 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273622400000",
"number": "1427376672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3434 W 6TH ST STE 312",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900202578",
"telephone_number": "213-388-4556",
"fax_number": "213-388-4557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3434 W 6TH ST STE 312",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900202578",
"telephone_number": "213-388-4556",
"fax_number": "213-388-4557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "PHILLIP",
"middle_name": "JUNG-WAN",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-12",
"last_updated": "2010-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "24057",
"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 May 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.