Active NPI
Jeannie Sook Kang, LAC
- Acupuncturist
- Los Angeles, CA
National Provider Identifier
1154462216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 6684
- Practice address
- 822 S Robertson Blvd
#105
Los Angeles, CA 90035-1613 - Phone
- (310) 854-7788
- Fax
- (310) 854-3308
- NPI assigned
- Feb 10, 2007
- 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 | 6684 | CA | Primary |
Addresses
Primary practice location
822 S Robertson Blvd
#105
Los Angeles, CA 90035-1613
Mailing address
547 N Plymouth Blvd
Los Angeles, CA 90004-1410
Phone (323) 871-4821
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 |
|---|---|---|---|
| 6684 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154462216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "547 N PLYMOUTH BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900041410",
"telephone_number": "323-871-4821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "822 S ROBERTSON BLVD",
"address_2": "#105",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900351613",
"telephone_number": "310-854-7788",
"fax_number": "310-854-3308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANG",
"first_name": "JEANNIE",
"middle_name": "SOOK",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "6684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.