Ebenezer Wellness Center, Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A86714 Issued in CA

Legal business name

EBENEZER WELLNESS CENTER, INC.

Practice address

16261 Laguna Canyon Rd
Suite 100
Irvine, CA 92618-3608

Phone

(714) 636-3886

NPI assigned

May 23, 2014

Organization subpart

No

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

Authorized official

Name

Junghee Kim, L.AC

Title

Vice President

Phone

(714) 618-3942

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jiwong Kim, L.AC

  • Acupuncturist
  • Irvine, CA
  • NPI 1487056651
  NPD (past)

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400803200000",
    "number": "1114339272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16261 LAGUNA CANYON RD",
            "address_2": "SUITE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183608",
            "telephone_number": "714-636-3886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16261 LAGUNA CANYON RD",
            "address_2": "SUITE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183608",
            "telephone_number": "714-636-3886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBENEZER WELLNESS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-23",
        "last_updated": "2014-05-23",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JUNGHEE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "714-618-3942",
        "authorized_official_credential": "L.AC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A86714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL BOARD",
            "identifier": "A86714",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andersen Eagle
• Mona Kiyomi Eakin, AMFT
• Robin John Eapen
• Easter Seals Southern California, Inc
• Mamak Eatesam, M.D.
• Sara Eberlein, APCC
• Armando Echeverria
• Briana Eckels, LCSW
• Hope Ann Eckman, OTR/L
• Eden by Enhance LLC

• General Practice Physician in Irvine, CA
• Providers in Irvine, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2014; 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.