Active NPI
Kelly Eunjoo Kim, LAC
- Acupuncturist
- Newport Beach, CA
National Provider Identifier
1104065523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 11276
- Practice address
- 280 Newport Center Dr
Suite 200
Newport Beach, CA 92660-7526 - Phone
- (949) 729-9987
- NPI assigned
- Feb 9, 2009
- Sex
- Female
- 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 | 11276 | CA | Primary |
Addresses
Primary practice location
280 Newport Center Dr
Suite 200
Newport Beach, CA 92660-7526
Mailing address
280 Newport Center Dr
Suite 200
Newport Beach, CA 92660-7526
Phone (949) 729-9987
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 |
|---|---|---|---|
| 11276 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234137600000",
"number": "1104065523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 NEWPORT CENTER DR",
"address_2": "SUITE 200",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926607526",
"telephone_number": "949-729-9987"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 NEWPORT CENTER DR",
"address_2": "SUITE 200",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926607526",
"telephone_number": "949-729-9987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "KELLY",
"middle_name": "EUNJOO",
"name_prefix": "Mrs.",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-09",
"last_updated": "2009-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "11276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.