Active NPI
Sooyeol Kim
- Acupuncturist
- Rancho Cucamonga, CA
National Provider Identifier
1245773027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 17443
- Practice address
- 9327 Fairway View PL Ste 204
Rancho Cucamonga, CA 91730-0969 - Phone
- (675) 341-2125
- NPI assigned
- Nov 28, 2016
- 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 | 17443 | CA | Primary |
Addresses
Primary practice location
9327 Fairway View PL Ste 204
Rancho Cucamonga, CA 91730-0969
Mailing address
9327 Fairway View PL Ste 204
Rancho Cucamonga, CA 91730-0969
Phone (675) 341-2125
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 |
|---|---|---|---|
| 17443 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641427200000",
"number": "1245773027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9327 FAIRWAY VIEW PL STE 204",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917300969",
"telephone_number": "675-341-2125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9327 FAIRWAY VIEW PL STE 204",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917300969",
"telephone_number": "675-341-2125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SOOYEOL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-11-28",
"last_updated": "2022-01-06",
"certification_date": "2022-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "17443",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.