Jai Wook Kim, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC17806 Issued in CA

Practice address

1321 N Harbor Blvd Ste 205
Fullerton, CA 92835-4130

Phone

(818) 917-9642

NPI assigned

Aug 18, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1164140802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 N HARBOR BLVD STE 205",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354130",
            "telephone_number": "818-917-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 N HARBOR BLVD STE 205",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928354130",
            "telephone_number": "818-917-9642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JAI WOOK",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC17806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUPUNCTURE",
            "identifier": "AC17806",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "AcuwayClinic",
            "affiliation": "N",
            "address_1": "1321 N Harbor Blvd Ste 205",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928354130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hwaki Kim, RPH
• Hyun Jung Kim, ACUPUNCTURIST
• Hyunsoo Kim
• Jae Hee Kim
• Jae K Kim, M.D.
• Jamie Kim, OTR/L
• Jane Kim, PA-C
• Janet Hojung Kim, D.D.S
• Janghoi Kim, L.AC.
• Jason Kim, DDS

• Acupuncturist in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.

Verify at the official NPI Registry.