Active NPI
Byungheon Moon, L.AC
- Acupuncturist
- Buena Park, CA
National Provider Identifier
1083968697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 15073
- Practice address
- 6056 Beach Blvd
Buena Park, CA 90621-2301 - Phone
- (714) 980-1364
- NPI assigned
- Nov 5, 2012
- Last updated
- Nov 9, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AC15073 | CA | |
| Acupuncturist | 171100000X | 15073 | CA | Primary |
Addresses
Primary practice location
6056 Beach Blvd
Buena Park, CA 90621-2301
Mailing address
6056 Beach Blvd
Buena Park, CA 90621-2301
Phone (714) 980-1364
Other names 1
- Clark Moon
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 |
|---|---|---|---|
| 15073 | CA | MD | Acupuncturist |
| AC15073 | CA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Double S Company | Acupuncturist | Current | Accepting new patients |
Locations
6056 Beach Blvd
Buena Park, CA 90621
Phone (714) 735-8285
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762646400000",
"number": "1083968697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6056 BEACH BLVD",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906212301",
"telephone_number": "714-980-1364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6056 BEACH BLVD",
"city": "BUENA PARK",
"state": "CA",
"postal_code": "906212301",
"telephone_number": "714-980-1364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "BYUNGHEON",
"credential": "L.AC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-11-05",
"last_updated": "2025-11-09",
"certification_date": "2025-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC15073",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "15073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CLARK",
"last_name": "MOON",
"credential": "L.AC",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Buena Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.