Active NPI
Ke Sung Kwak, D.C.
- Acupuncturist
- Los Angeles, CA
National Provider Identifier
1215178082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC9503
- Practice address
- 1730 W Olympic Blvd
Suite 100
Los Angeles, CA 90015-1019 - Phone
- (213) 384-1100
- Fax
- (213) 384-1101
- NPI assigned
- Mar 9, 2009
- Last updated
- Mar 9, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC30810 | CA | |
| Acupuncturist | 171100000X | AC9503 | CA | Primary |
Addresses
Primary practice location
1730 W Olympic Blvd
Suite 100
Los Angeles, CA 90015-1019
Mailing address
1730 W Olympic Blvd
Suite 100
Los Angeles, CA 90015-1019
Phone (213) 384-1100
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 |
|---|---|---|---|
| DC30810 | CA | MD | Chiropractor |
| AC9503 | CA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samra Hamsoa, Inc. | Chiropractor | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Samra Acupuncture Spinal Center
- Acupuncturist
- Los Angeles, CA
- NPI 1427299270
Chiropractor
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236556800000",
"number": "1215178082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1730 W OLYMPIC BLVD",
"address_2": "SUITE 100",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900151019",
"telephone_number": "213-384-1100",
"fax_number": "213-384-1101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1730 W OLYMPIC BLVD",
"address_2": "SUITE 100",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900151019",
"telephone_number": "213-384-1100",
"fax_number": "213-384-1101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWAK",
"first_name": "KE",
"middle_name": "SUNG",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-03-09",
"last_updated": "2009-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC30810",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC9503",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.