NPIMap

Organization Active NPI

Pro Care Pain Clinic

  • Acupuncturist
  • Los Angeles, CA
National Provider Identifier
1366992877
Registry record updated Oct 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC16014 Issued in CA
Legal business name
PRO CARE PAIN CLINIC
Practice address
621 S Virgil Ave Ste 310
Los Angeles, CA 90005-4047
Phone
(213) 487-1025
Fax
(888) 450-1242
NPI assigned
Oct 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2016

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

Authorized official

Name
Myongseok Song
Title
Acupuncturist
Phone
(213) 487-1025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 171100000X AC16014 CA Primary

Addresses

Primary practice location

621 S Virgil Ave Ste 310
Los Angeles, CA 90005-4047

Mailing address

621 S Virgil Ave Ste 310
Los Angeles, CA 90005-4047
Phone (213) 487-1025

National Provider Directory

National Provider Directory
Tax ID family
Pro Care Pain Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

621 S Virgil Ave
Ste 310
Los Angeles, CA 90005
Phone (213) 382-5566

NPI Registry JSON

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

{
    "created_epoch": "1475798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475798400000",
    "number": "1366992877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S VIRGIL AVE STE 310",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900054047",
            "telephone_number": "213-487-1025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S VIRGIL AVE STE 310",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900054047",
            "telephone_number": "213-487-1025",
            "fax_number": "888-450-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO CARE PAIN CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-07",
        "last_updated": "2016-10-07",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "MYONGSEOK",
        "authorized_official_title_or_position": "ACUPUNCTURIST",
        "authorized_official_telephone_number": "213-487-1025"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC16014",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 7, 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.

Verify at the official NPI Registry.