Active NPI
Gichul Bae
- Acupuncturist
- Los Angeles, CA
National Provider Identifier
1053600809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC13472
- Practice address
- 440 Shatto PL
Ste 208
Los Angeles, CA 90020-1836 - Phone
- (213) 382-2030
- Fax
- (866) 438-5974
- NPI assigned
- Apr 1, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC13472 | CA | Primary |
Addresses
Primary practice location
440 Shatto PL
Ste 208
Los Angeles, CA 90020-1836
Mailing address
440 Shatto PL
Ste 208
Los Angeles, CA 90020-1836
Phone (213) 382-2030
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AC13472 | Other | CA | ACUPUNCTURE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| AC13472 | CA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri Star Orthopaedics | Acupuncturist | Past | 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": "1301616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301616000000",
"number": "1053600809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 SHATTO PL",
"address_2": "STE 208",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900201836",
"telephone_number": "213-382-2030",
"fax_number": "866-438-5974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "440 SHATTO PL",
"address_2": "STE 208",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900201836",
"telephone_number": "213-382-2030",
"fax_number": "866-438-5974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAE",
"first_name": "GICHUL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-01",
"last_updated": "2011-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC13472",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACUPUNCTURE",
"identifier": "AC13472",
"state": "CA"
}
],
"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 Apr 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.