NPIMap

Individual provider Active NPI

Dong Kim, D.C.

  • Chiropractor
  • Glendale, CA
National Provider Identifier
1962538728
Registry record updated May 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 26564 Issued in CA
Practice address
1111 N. Brand Blvd.
402
Glendale, CA 91202-3071
Phone
(818) 243-6206
Fax
(818) 243-2908
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC952 HI
Chiropractor 111N00000X DC 26564 CA Primary

Addresses

Primary practice location

1111 N. Brand Blvd.
402
Glendale, CA 91202-3071

Mailing address

1111 N. Brand Blvd.
402
Glendale, CA 91202
Phone (818) 243-6206

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 26564CAMDChiropractor
DC952HIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lim'S Action Chiropractic, LLC Chiropractor PastSince Oct 7, 2014 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430524800000",
    "number": "1962538728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 N. BRAND BLVD.",
            "address_2": "402",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91202",
            "telephone_number": "818-243-6206",
            "fax_number": "818-243-2908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 N. BRAND BLVD.",
            "address_2": "402",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912023071",
            "telephone_number": "818-243-6206",
            "fax_number": "818-243-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DONG",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2015-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "HI",
            "license": "DC952",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 26564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.