Active NPI
Eun-Ju Park
- Acupuncturist
- Pleasanton, CA
National Provider Identifier
1366813610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC16610
- Practice address
- 5924 Stoneridge Dr
Suite 204a
Pleasanton, CA 94588-2887 - Phone
- (925) 918-2649
- NPI assigned
- Oct 13, 2015
- 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 | AC16610 | CA | Primary |
Addresses
Primary practice location
5924 Stoneridge Dr
Suite 204a
Pleasanton, CA 94588-2887
Mailing address
5278 Ridgevale Way
Pleasanton, CA 94566-5425
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 |
|---|---|---|---|
| AC16610 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457568000000",
"number": "1366813610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5278 RIDGEVALE WAY",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945665425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5924 STONERIDGE DR",
"address_2": "SUITE 204A",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945882887",
"telephone_number": "925-918-2649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "EUN-JU",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-13",
"last_updated": "2016-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC16610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasanton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.