NPIMap

Organization Active NPI

Full Bloom Acupuncture

  • Acupuncturist
  • Santa Monica, CA
National Provider Identifier
1194177915
Registry record updated Jul 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
16792 Issued in CA
Legal business name
FULL BLOOM ACUPUNCTURE
Practice address
655 Copeland CT Apt C
Santa Monica, CA 90405-4478
Phone
(323) 717-5433
NPI assigned
Jul 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2016

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

Authorized official

Name
Alec Bridges, L AC.NPI 1598137101
Title
Owner
Phone
(323) 717-5433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X 16792 CA Primary

Addresses

Primary practice location

655 Copeland CT Apt C
Santa Monica, CA 90405-4478

Mailing address

655 Copeland CT Apt C
Santa Monica, CA 90405-4478
Phone (323) 717-5433

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1467676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467676800000",
    "number": "1194177915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 COPELAND CT APT C",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904054478",
            "telephone_number": "323-717-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 COPELAND CT APT C",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904054478",
            "telephone_number": "323-717-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL BLOOM ACUPUNCTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-05",
        "last_updated": "2016-07-05",
        "status": "A",
        "authorized_official_last_name": "BRIDGES",
        "authorized_official_first_name": "ALEC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-717-5433",
        "authorized_official_credential": "L AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "16792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; 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.