Active NPI
Jin Hee Kwon, D.C.
- Chiropractor
- Victorville, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC29535
- Practice address
- 12640 Hesperia Rd Ste D
Victorville, CA 92395-7753 - Phone
- (760) 684-4143
- Fax
- (760) 684-8111
- NPI assigned
- May 24, 2005
- Sex
- Female
- Sole proprietor
- Yes
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 | DC29535 | CA | Primary |
Addresses
Primary practice location
12640 Hesperia Rd Ste D
Victorville, CA 92395-7753
Mailing address
12640 Hesperia Rd Ste D
Victorville, CA 92395-7753
Phone (760) 684-4143
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC29535 | Other | CA | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050217000562 | CA | Practitioner - Chiropractic | 8628020674 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC29535 | CA | MD | Chiropractor |
| 29535 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tobias Moeller-Bertram MD Corporation | Current | Accepting new patients | |
| Tobias Moeller-Bertram MD Corporation | Current | Accepting new patients | |
| Kwon Chiropractic Corporation | Chiropractor | Past | Accepting new patients |
Locations
44630 Monterey Ave
Ste 100
Palm Desert, CA 92260
Phone (760) 340-4290
36101 Bob Hope Dr
Ste A
Rancho Mirage, CA 92270
Phone (760) 321-1315
12830 Hesperia Rd
Ste C
Victorville, CA 92395
Phone (760) 684-8999
12640 Hesperia Rd
Ste D
Victorville, CA 92395
Phone (760) 684-4143
Organizations & group practices 10
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.
-
- Pain Medicine (Anesthesiology) Physician
- Rancho Mirage, CA
- NPI 1922440684
CA
-
- Durable Medical Equipment & Medical Supplies
- Indio, CA
- NPI 1861389199
-
- Chiropractor
- Fullerton, CA
- NPI 1568851533
-
- Durable Medical Equipment & Medical Supplies
- Riverside, CA
- NPI 1154218451
-
- Durable Medical Equipment & Medical Supplies
- Indio, CA
- NPI 1336036656
-
- Pain Medicine (Anesthesiology) Physician
- San Jacinto, CA
- NPI 1366339673
-
- Durable Medical Equipment & Medical Supplies
- Victorville, CA
- NPI 1376430678
-
- Durable Medical Equipment & Medical Supplies
- Victorville, CA
- NPI 1538056932
-
- Durable Medical Equipment & Medical Supplies
- Palm Springs, CA
- NPI 1750278073
-
- Oxygen Equipment & Supplies (DME)
- Rancho Mirage, CA
- NPI 1790663391
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Cleveland Chiropractic College - Los Angeles, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tobias Moeller-Bertram MD Corporation
Practice addresses (Care Compare)
12640 Hesperia Rd
Suite D
Victorville, CA 92395-7753
Phone (760) 684-4143
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772409600000",
"number": "1891798674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12640 HESPERIA RD STE D",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923957753",
"telephone_number": "760-684-4143",
"fax_number": "760-684-8111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12640 HESPERIA RD STE D",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923957753",
"telephone_number": "760-684-4143",
"fax_number": "760-684-8111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWON",
"first_name": "JIN",
"middle_name": "HEE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-05-24",
"last_updated": "2026-03-02",
"certification_date": "2026-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC29535",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "DC29535",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.