Individual provider Active NPI

Daniel Kwangson Yi, D.C.

  • Chiropractor
  • Los Angeles, CA
National Provider Identifier
1669479176
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC25635 Issued in CA
Practice address
4017 Wilshire Blvd
Los Angeles, CA 90010-3401
Phone
(213) 384-8888
Fax
(213) 384-8887
NPI assigned
Jun 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC25635 CA Primary

Addresses

Primary practice location

4017 Wilshire Blvd
Los Angeles, CA 90010-3401

Mailing address

4017 Wilshire Blvd
Los Angeles, CA 90010-3401
Phone (213) 384-8888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040303001350 CA Practitioner - Chiropractic 0941197891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Medical Center of Corona IncGroup PAC ID 4981904737, 10 clinicians

Practice addresses (Care Compare)

2250 S Main St
Suite 203
Corona, CA 92882-2506
Phone (951) 737-1252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC25635CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Medical Center of Corona Inc. CurrentSince Jan 17, 2023 Accepting new patients
Greater Los Angeles Oncology Medical Corporation Past Accepting new patients
Pirritano Chiropractic Corporation Chiropractor PastSince Jan 17, 2023 Accepting new patients

Locations

2250 S Main St
Ste 203
Corona, CA 92882
Phone (800) 595-2447

370 W 6th St
Ste 100
San Bernardino, CA 92401
Phone (909) 381-3492

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1669479176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4017 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103401",
            "telephone_number": "213-384-8888",
            "fax_number": "213-384-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4017 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103401",
            "telephone_number": "213-384-8888",
            "fax_number": "213-384-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YI",
        "first_name": "DANIEL",
        "middle_name": "KWANGSON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC25635",
            "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 Jul 13, 2026; 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.