Active NPI
Youn Kgan Kim
- Acupuncturist
- Los Angeles, CA
National Provider Identifier
1235670969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 11961
- Practice address
- 903 Crenshaw Blvd
#302
Los Angeles, CA 90019-1964 - Phone
- (323) 889-9114
- Fax
- (323) 938-6642
- NPI assigned
- Mar 14, 2017
- 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 | 11961 | CA | Primary |
Addresses
Primary practice location
903 Crenshaw Blvd
#302
Los Angeles, CA 90019-1964
Mailing address
903 Crenshaw Blvd
#302
Los Angeles, CA 90019-1964
Phone (323) 889-9114
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489449600000",
"number": "1235670969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "903 CRENSHAW BLVD",
"address_2": "#302",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900191964",
"telephone_number": "323-889-9114",
"fax_number": "323-938-6642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "903 CRENSHAW BLVD",
"address_2": "#302",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900191964",
"telephone_number": "323-889-9114",
"fax_number": "323-938-6642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "YOUN KGAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-14",
"last_updated": "2017-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "11961",
"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 14, 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.