Individual provider Active NPI

Jong Hee Jeon, L. AC.

  • Acupuncturist
  • West Covina, CA
National Provider Identifier
1174883144
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC11548 Issued in CA
Practice address
2865 E Valley Blvd
#25
West Covina, CA 91792-3160
Phone
(714) 350-4781
NPI assigned
May 23, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC11548 CA Primary

Addresses

Primary practice location

2865 E Valley Blvd
#25
West Covina, CA 91792-3160

Mailing address

2865 E Valley Blvd
#25
West Covina, CA 91792-3160
Phone (714) 350-4781

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

LicenseStateTypeSpecialty
AC11548CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1174883144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 E VALLEY BLVD",
            "address_2": "#25",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917923160",
            "telephone_number": "714-350-4781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 E VALLEY BLVD",
            "address_2": "#25",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917923160",
            "telephone_number": "714-350-4781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEON",
        "first_name": "JONG",
        "middle_name": "HEE",
        "credential": "L. AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-23",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC11548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.