Individual provider Active NPI

Sangjin Chun, L.AC.

  • Acupuncturist
  • Huntington Park, CA
National Provider Identifier
1114047644
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC4955 Issued in CA
Practice address
7128 Pacific Blvd # H
Huntington Park, CA 90255-4776
Phone
(213) 448-3028
Fax
(323) 277-9230
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC4955 CA Primary

Addresses

Primary practice location

7128 Pacific Blvd # H
Huntington Park, CA 90255-4776

Mailing address

7128 Pacific Blvd # H
Huntington Park, CA 90255-4776
Phone (213) 448-3028

Other identifiers 1

IdentifierTypeStateIssuer
3093829MedicaidCA

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
AC4955CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383609600000",
    "number": "1114047644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7128 PACIFIC BLVD # H",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902554776",
            "telephone_number": "213-448-3028",
            "fax_number": "323-277-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7128 PACIFIC BLVD # H",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902554776",
            "telephone_number": "213-448-3028",
            "fax_number": "323-277-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUN",
        "first_name": "SANGJIN",
        "name_prefix": "Mr.",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2013-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC4955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3093829",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; 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.