NPIMap

Organization Active NPI

Acucenter of la, Inc

  • Chiropractor
  • Los Angeles, CA
National Provider Identifier
1295140929
Registry record updated Feb 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC32983 Issued in CA
Legal business name
ACUCENTER OF LA, INC
Practice address
4465 Wilshire Blvd Ste 303
Los Angeles, CA 90010-3716
Phone
(323) 936-4000
Fax
(323) 936-4001
NPI assigned
Jun 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2015

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

Authorized official

Name
Dr. Bongkyun Suh, D.C., L.AC.NPI 1912937442
Title
Ceo
Phone
(323) 936-2828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X DC32983 CA Primary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC8688 CA
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC9809 CA

Addresses

Primary practice location

4465 Wilshire Blvd Ste 303
Los Angeles, CA 90010-3716

Mailing address

4465 Wilshire Blvd Ste 303
Los Angeles, CA 90010-3716
Phone (323) 936-4000

Other identifiers 3

IdentifierTypeStateIssuer
AC9809MedicaidCA
DC32983MedicaidCA
AC8688MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140729000641 CA Part B Supplier - Clinic/Group Practice 2961628979 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424131200000",
    "number": "1295140929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4465 WILSHIRE BLVD STE 303",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103716",
            "telephone_number": "323-936-4000",
            "fax_number": "323-936-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 WILSHIRE BLVD STE 303",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103716",
            "telephone_number": "323-936-4000",
            "fax_number": "323-936-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACUCENTER OF LA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-20",
        "last_updated": "2015-02-17",
        "status": "A",
        "authorized_official_last_name": "SUH",
        "authorized_official_first_name": "BONGKYUN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-936-2828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., L.AC."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC32983",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC8688",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC9809",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AC9809",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DC32983",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AC8688",
            "state": "CA"
        }
    ],
    "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 Feb 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.