Active NPI
Yeon Ok Kim
- Acupuncturist
- Riverside, CA
National Provider Identifier
1336642735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 10709
- Practice address
- 6717 Indiana Ave
Riverside, CA 92506-4263 - Phone
- (951) 680-0204
- NPI assigned
- Mar 12, 2018
- Last updated
- Mar 12, 2018
- Sex
- Female
- 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 | 10709 | CA | Primary |
Addresses
Primary practice location
6717 Indiana Ave
Riverside, CA 92506-4263
Mailing address
6717 Indiana Ave
Riverside, CA 92506-4263
Phone (951) 680-0204
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 |
|---|---|---|---|
| 10709 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Acupuncture | Acupuncturist | Past | Accepting new patients |
| Acu East Medi Inc | Acupuncturist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Acupuncturist
- Riverside, CA
- NPI 1225586530
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520812800000",
"number": "1336642735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6717 INDIANA AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925064263",
"telephone_number": "951-680-0204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6717 INDIANA AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925064263",
"telephone_number": "951-680-0204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "YEON OK",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-12",
"last_updated": "2018-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "10709",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.