NPIMap

Organization Active NPI

South Baylo University

Doing business as South Baylo University LA Clinic

  • Acupuncturist
  • Los Angeles, CA
National Provider Identifier
1235483025
Registry record updated Mar 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Legal business name
SOUTH BAYLO UNIVERSITY
Doing business as
South Baylo University LA Clinic
Practice address
2727 W 6TH St
Los Angeles, CA 90057-3111
Phone
(213) 738-1974
Fax
(213) 738-1923
NPI assigned
Nov 1, 2012
Last updated
Mar 24, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2017

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

Authorized official

Name
Prof. Deuk S Jang, O.M.D., L.AC
Title
Clinic Director
Phone
(213) 738-1974

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X NU Primary

Addresses

Primary practice location

2727 W 6TH St
Los Angeles, CA 90057-3111

Mailing address

2727 W 6TH St
Los Angeles, CA 90057-3111
Phone (213) 738-1974

Other names 1

  • South Baylo University LA Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
South Baylo University3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2727 W 6th St
Los Angeles, CA 90057
Phone (213) 738-0712

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490313600000",
    "number": "1235483025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 W 6TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573111",
            "telephone_number": "213-738-1974",
            "fax_number": "213-738-1923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 W 6TH ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900573111",
            "telephone_number": "213-738-1974",
            "fax_number": "213-738-1923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAYLO UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-01",
        "last_updated": "2017-03-24",
        "status": "A",
        "authorized_official_last_name": "JANG",
        "authorized_official_first_name": "DEUK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "213-738-1974",
        "authorized_official_name_prefix": "Prof.",
        "authorized_official_credential": "O.M.D., L.AC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Baylo University LA Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 24, 2017; 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.