Active NPI
John Jun Ming Xu, L. AC.
- Acupuncturist
- Monterey Park, CA
National Provider Identifier
1205900115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC5791
- Practice address
- 619 S Atlantic Blvd
Monterey Park, CA 91754-3817 - Phone
- (626) 300-8986
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | AC5791 | CA | Primary |
Addresses
Primary practice location
619 S Atlantic Blvd
Monterey Park, CA 91754-3817
Mailing address
5082 Sereno Dr
Temple City, CA 91780-3037
Phone (626) 287-2377
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AC0057910 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| AC5791 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1205900115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5082 SERENO DR",
"city": "TEMPLE CITY",
"state": "CA",
"postal_code": "917803037",
"telephone_number": "626-287-2377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 S ATLANTIC BLVD",
"city": "MONTEREY PARK",
"state": "CA",
"postal_code": "917543817",
"telephone_number": "626-300-8986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "XU",
"first_name": "JOHN",
"middle_name": "JUN MING",
"credential": "L. AC.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC5791",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "AC0057910",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monterey Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.