TAE KYUNG KIM (NPI# 1629533666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629533666 |
| Entity Type | Individual |
| Full Name | TAE KYUNG KIM |
| Credential | DC |
| Practice Address |
11441 Heacock St Ste E Moreno Valley CA 92557-7907 |
| Practice Telephone | 9515671476 |
| Mailing Telephone | 9515671476 |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2019-02-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | DC28107 | CA | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902374101 | Tae Kyung Kim | Student in an Organized Health Care Education/Training Program | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2018-11-06 |
| Street Address |
11441 HEACOCK ST STE E |
| City | MORENO VALLEY |
| State | CA |
| Zip Code | 92557-7907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952713018 | Misook Doo | Acupuncturist | 11441 Heacock St Ste E, Moreno Valley, CA 92557-7907 | 2014-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598314577 | Knight Rider Transport Inc | Private Vehicle | 21334 Ocasey Ct, Moreno Valley, CA 92557 | 2019-09-11 |
| 1679041495 | Shaping Pathways | Community/Behavioral Health | 11627 Mccully Court, Moreno Valley, CA 92557 | 2018-11-09 |
| 1710485644 | Torie Curiel | Behavior Technician | 12125 Day St E301, Moreno Valley, CA 92557 | 2018-01-25 |
| 1164949921 | Phyllis Yvonne Miller | Behavioral Analyst | 15450 Casa Grande St, Moreno Valley, CA 92557 | 2017-08-23 |
| 1255855912 | Natalie Maria-vega Cortinas | Specialist/Technologist | 12348 Kasota Ct., Moreno Valley, CA 92557 | 2017-08-03 |
| 1942720263 | Shenna Pontier Brown | Licensed Vocational Nurse | 12031 Poutous Ct, Moreno Valley, CA 92557 | 2017-06-27 |
| 1104209733 | Saira Medrano | Counselor | 11966 Villa Hermosa, Moreno Valley, CA 92557 | 2015-07-01 |
| 1295071405 | Maura Sauls | Counselor | 9963 Paseo Corralito, Moreno Valley, CA 92557 | 2012-12-14 |
| 1992919583 | Jody Willetts | Technician, Other | 11480 Tiffany Lane, Moreno Valley, CA 92557 | 2007-05-10 |
| 1457564841 | Derrick Trigenza Smith | Dental Hygienist | 23569 Sunnymead Ranch Parkway, Moreno Valley, CA 92557 | 2007-05-08 |
| Find all providers in zip 92557 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346726486 | Elias Y. Rached | Chiropractor | 23846 Sunnymead Blvd Ste 4, Moreno Valley, CA 92553 | 2018-07-12 |
| 1376852251 | Chang Cho Chung | Chiropractor | 24578 Sunnymead Bl., # C/d, Moreno Valley, CA 92553 | 2010-09-27 |
| 1598927378 | Ronald Soriano | Chiropractor | 11365 Quincy St, Moreno Valley, CA 92555-6586 | 2008-07-02 |
| 1821269440 | Carla Asante Mcmorris | Chiropractor | 24580 Sunnymead Blvd, H, Moreno Valley, CA 92553-3761 | 2008-03-23 |
| 1407998149 | Kanak D. Patel | Chiropractor | 16420 Perris Blvd Ste Q, Moreno Valley, CA 92551-1136 | 2007-02-12 |
| 1962543504 | Sam Putres Khumooro | Chiropractor | 23080 Alessandro Blvd Ste 204, Moreno Valley, CA 92553-9674 | 2007-02-08 |
| 1720135122 | Derick J Lajom | Chiropractor | 23750 Alessandro Blvd Ste I102, Moreno Valley, CA 92553-8815 | 2007-01-05 |
| 1205991098 | Patrick Daniel Fairchild | Chiropractor | 23890 Alessandro Blvd Suite F, Moreno Valley, CA 82553 | 2006-12-22 |
| 1083784870 | Norman E Corlew | Chiropractor | 23890 Alessandro Blvd, Suite F, Moreno Valley, CA 92553-0312 | 2006-11-08 |
| 1780768200 | Christina Burkhardt | Chiropractor | 25400 Alessandro Blvd, 102, Moreno Valley, CA 92553-4319 | 2006-10-24 |
| Find all providers in MORENO VALLEY | ||||
| City | MORENO VALLEY |
| Zip Code | 92557 |
Please comment or provide details below to improve the information on TAE KYUNG KIM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.