NPIMap

Organization Active NPI

South Baylo University

  • Acupuncturist
  • Anaheim, CA
National Provider Identifier
1124169958
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
283-2036-4 Issued in CA
Legal business name
SOUTH BAYLO UNIVERSITY
Practice address
1126 N Brookhurst St
Ste.#301
Anaheim, CA 92801-1702
Phone
(714) 535-3886
Fax
(714) 535-3919
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
David Park
Title
Presidentand Ceo
Phone
(714) 533-1495

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X 283-2036-4 CA Primary

Addresses

Primary practice location

1126 N Brookhurst St
Ste.#301
Anaheim, CA 92801-1702

Mailing address

1126 N Brookhurst St
Ste.#301
Anaheim, CA 92801-1702
Phone (714) 535-3886

Other names 1

  • SOUTH BAYLO ACUPUNCTURE&HERB CENTER Other name

National Provider Directory

National Provider Directory
Tax ID family
South Baylo University3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1126 N Brookhurst St
Ste 301
Anaheim, CA 92801
Phone (714) 535-3886

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124169958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 N BROOKHURST ST",
            "address_2": "STE.#301",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011702",
            "telephone_number": "714-535-3886",
            "fax_number": "714-535-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 N BROOKHURST ST",
            "address_2": "STE.#301",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011702",
            "telephone_number": "714-535-3886",
            "fax_number": "714-535-3919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAYLO UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENTAND CEO",
        "authorized_official_telephone_number": "714-533-1495"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "283-2036-4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH BAYLO ACUPUNCTURE&HERB CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.