Active NPI
Sim Tuzun Davidson, M.S.O.M, LAC
- Acupuncturist
- South Pasadena, CA
National Provider Identifier
1386089563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC 15018
- Practice address
- 1416 El Centro St # 300
South Pasadena, CA 91030-3202 - Phone
- (626) 403-5018
- NPI assigned
- May 1, 2013
- 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 | AC 15018 | CA | Primary |
Addresses
Primary practice location
1416 El Centro St # 300
South Pasadena, CA 91030-3202
Mailing address
227 N Avenue 66
Los Angeles, CA 90042-2926
Phone (323) 620-4010
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 15018 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367539200000",
"number": "1386089563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "227 N AVENUE 66",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900422926",
"telephone_number": "323-620-4010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1416 EL CENTRO ST # 300",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910303202",
"telephone_number": "626-403-5018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "SIM",
"middle_name": "TUZUN",
"credential": "M.S.O.M, LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-01",
"last_updated": "2013-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC 15018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.