Individual provider Active NPI

DO Jun Kim

  • Acupuncturist
  • Norwalk, CA
National Provider Identifier
1205406840
Registry record updated Jun 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC12676 Issued in CA
Practice address
11637 The PLZ # 46
Norwalk, CA 90650-3930
Phone
(310) 422-2637
NPI assigned
Jun 27, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC12676 CA Primary

Addresses

Primary practice location

11637 The PLZ # 46
Norwalk, CA 90650-3930

Mailing address

8091 Hickory Dr
Buena Park, CA 90620-2225
Phone (310) 422-2637

Other practice location 1

1706 W Orangethorpe Ave Ste D
Fullerton, CA 92833-4556
Phone (310) 422-2637

Other names 1

  • Dojun Kim Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Undefined Physician Type (Specify)
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7235 Orangethorpe Ave
Buena Park, CA 90621-3311

8091 Hickory Dr
Buena Park, CA 90620-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AC12676CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
DK Acupuncture, Inc. Acupuncturist CurrentSince Aug 8, 2021 Accepting new patients

Locations

7235 Orangethorpe Ave
Buena Park, CA 90621
Phone (714) 735-9735

11637 The Plz
#46
Norwalk, CA 90650
Phone (310) 422-2637

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1624752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624752000000",
    "number": "1205406840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8091 HICKORY DR",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906202225",
            "telephone_number": "310-422-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11637 THE PLZ # 46",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906503930",
            "telephone_number": "310-422-2637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1706 W Orangethorpe Ave Ste D",
            "address_purpose": "LOCATION",
            "city": "Fullerton",
            "state": "CA",
            "postal_code": "928334556",
            "country_code": "US",
            "telephone_number": "310-422-2637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "DO JUN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-27",
        "last_updated": "2021-06-27",
        "certification_date": "2021-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC12676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOJUN",
            "last_name": "KIM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Norwalk, CA

Sources for this page

Verify at the official NPI Registry.