Active NPI
Joon Kim, L.AC.
- Acupuncturist
- Cupertino, CA
National Provider Identifier
1063882249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC 15837
- Practice address
- 20410 Town Center LN Ste 150
Cupertino, CA 95014-3230 - Phone
- (408) 384-8134
- NPI assigned
- Oct 1, 2015
- Last updated
- Oct 1, 2015
- Sex
- Male
- Sole proprietor
- No
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 | AC 15837 | CA | Primary |
Addresses
Primary practice location
20410 Town Center LN Ste 150
Cupertino, CA 95014-3230
Mailing address
19133 Cozette LN
Cupertino, CA 95014-3538
Phone (408) 605-1697
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 |
|---|---|---|---|
| AC 15837 | CA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marina Acupuncture Clinic, Inc. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Acupuncturist
- Cupertino, CA
- NPI 1104295930
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443657600000",
"number": "1063882249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19133 COZETTE LN",
"city": "CUPERTINO",
"state": "CA",
"postal_code": "950143538",
"telephone_number": "408-605-1697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20410 TOWN CENTER LN STE 150",
"city": "CUPERTINO",
"state": "CA",
"postal_code": "950143230",
"telephone_number": "408-384-8134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JOON",
"credential": "L.AC.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-10-01",
"last_updated": "2015-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC 15837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cupertino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.