Individual provider Active NPI

Jason Iljeong Yoon, L.AC

  • Acupuncturist
  • Los Angeles, CA
National Provider Identifier
1043747728
Registry record updated Dec 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC17676 Issued in CA
Practice address
640 S San Vicente Blvd #420
Los Angeles, CA 90048-4667
Phone
(323) 452-9555
Fax
(323) 452-9550
NPI assigned
May 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC17676 CA Primary

Addresses

Primary practice location

640 S San Vicente Blvd #420
Los Angeles, CA 90048-4667

Mailing address

640 S San Vicente Blvd #420
Los Angeles, CA 90048-4667
Phone (323) 452-9555

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

State licenses

LicenseStateTypeSpecialty
AC17676CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1043747728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S SAN VICENTE BLVD #420",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900484667",
            "telephone_number": "323-452-9555",
            "fax_number": "323-452-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S SAN VICENTE BLVD #420",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900484667",
            "telephone_number": "323-452-9555",
            "fax_number": "323-452-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "JASON",
        "middle_name": "ILJEONG",
        "credential": "L.AC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-12",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC17676",
            "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 Dec 27, 2018; 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.