Individual provider Active NPI

Jason Vincent Bukich, MSAOM L.AC.

  • Acupuncturist
  • Laguna Niguel, CA
National Provider Identifier
1063940435
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
17503 Issued in CA
Practice address
24586 Via del Oro
Laguna Niguel, CA 92677-7605
Phone
(949) 735-9981
NPI assigned
May 31, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 17503 CA Primary

Addresses

Primary practice location

24586 Via del Oro
Laguna Niguel, CA 92677-7605

Mailing address

24586 Via del Oro
Laguna Niguel, CA 92677-7605
Phone (949) 735-9981

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
17503CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063940435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24586 VIA DEL ORO",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926777605",
            "telephone_number": "949-735-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24586 VIA DEL ORO",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926777605",
            "telephone_number": "949-735-9981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKICH",
        "first_name": "JASON",
        "middle_name": "VINCENT",
        "credential": "MSAOM L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "17503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Niguel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.