Individual provider Active NPI

Misoon Jang, LAC

  • Acupuncturist
  • Laguna Hills, CA
National Provider Identifier
1073054102
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
17069 Issued in CA
Practice address
23412 Moulton Pkwy Ste 210
Laguna Hills, CA 92653-1744
Phone
(949) 588-0158
NPI assigned
Mar 8, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 17069 CA Primary

Addresses

Primary practice location

23412 Moulton Pkwy Ste 210
Laguna Hills, CA 92653-1744

Mailing address

23412 Moulton Pkwy Ste 210
Laguna Hills, CA 92653-1744
Phone (949) 588-0158

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
17069CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1488931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1073054102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23412 MOULTON PKWY STE 210",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531744",
            "telephone_number": "949-588-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23412 MOULTON PKWY STE 210",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531744",
            "telephone_number": "949-588-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANG",
        "first_name": "MISOON",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-08",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "17069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.