SE-Young Kim

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC00019702 Issued in CA

Practice address

1600 Dove St
Ste 210
Newport Beach, CA 92660-1417

Phone

(949) 943-6161

Fax

(949) 635-7818

NPI assigned

Apr 12, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1225724370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23331 EL TORO RD STE 107",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304809",
            "telephone_number": "949-943-6161",
            "fax_number": "949-625-7818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 DOVE ST",
            "address_2": "STE 210",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601417",
            "telephone_number": "949-943-6161",
            "fax_number": "949-635-7818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23331 El Toro Rd Ste 107",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "CA",
            "postal_code": "926304809",
            "country_code": "US",
            "telephone_number": "949-943-6161",
            "fax_number": "949-625-7818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "SE-YOUNG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "AC00019702",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC00019702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Kim
• Mi Young Kim, DDS
• Minkyung Kim, PSYD
• Robert Kim, M.D.
• Ruby Bora Kim
• Sook H Kim, D.O.
• Sora Kim, PHARM D.
• Suhyun Kim
• Sung Soo Kim, L.AC.
• Yang Ja Kim, M.D.

• Acupuncturist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.