Active NPI
Soonju Park
- Acupuncturist
- Los Angeles, CA
National Provider Identifier
1154619872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 13721
- Practice address
- 2727 W 6TH St
Los Angeles, CA 90057-3111 - Phone
- (213) 738-0712
- NPI assigned
- Jul 15, 2011
- Sex
- Female
- Sole proprietor
- No
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 | 13721 | CA | Primary |
Addresses
Primary practice location
2727 W 6TH St
Los Angeles, CA 90057-3111
Mailing address
2727 W 6TH St
Los Angeles, CA 90057
Phone (213) 738-0712
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AC 13721 | Other | CA | CALIFORNICA ACUPUNCTURIST |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1154619872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2727 W 6TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90057",
"telephone_number": "213-738-0712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2727 W 6TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900573111",
"telephone_number": "213-738-0712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "SOONJU",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "13721",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNICA ACUPUNCTURIST",
"identifier": "AC 13721",
"state": "CA"
}
],
"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 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.