Active NPI
Bon Seong Ku, L.AC
- Acupuncturist
- La Mirada, CA
National Provider Identifier
1316183122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC 12776
- Practice address
- 14764 Beach Blvd
La Mirada, CA 90638-4250 - Phone
- (714) 757-8685
- Fax
- (978) 334-5369
- NPI assigned
- Dec 29, 2008
- 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 | AC 12776 | CA | Primary |
Addresses
Primary practice location
14764 Beach Blvd
La Mirada, CA 90638-4250
Mailing address
14764 Beach Blvd
La Mirada, CA 90638-4250
Phone (714) 757-8685
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 |
|---|---|---|---|
| AC 12776 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524700800000",
"number": "1316183122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14764 BEACH BLVD",
"city": "LA MIRADA",
"state": "CA",
"postal_code": "906384250",
"telephone_number": "714-757-8685",
"fax_number": "978-334-5369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14764 BEACH BLVD",
"city": "LA MIRADA",
"state": "CA",
"postal_code": "906384250",
"telephone_number": "714-757-8685",
"fax_number": "978-334-5369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KU",
"first_name": "BON SEONG",
"name_prefix": "Mr.",
"credential": "L.AC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-29",
"last_updated": "2018-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC 12776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Mirada, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.