Active NPI
Ja Hyung Koo
- Acupuncturist
- Fullerton, CA
National Provider Identifier
1407225113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 16434
- Practice address
- 817 W Wilshire Ave
Fullerton, CA 92832-1649 - Phone
- (213) 435-0665
- Fax
- (714) 449-1399
- NPI assigned
- Sep 23, 2015
- 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 | 16434 | CA | Primary |
Addresses
Primary practice location
817 W Wilshire Ave
Fullerton, CA 92832-1649
Mailing address
817 W Wilshire Ave
Fullerton, CA 92832-1649
Phone (213) 435-0665
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 |
|---|---|---|---|
| 16434 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K&Y Acupuncture | Acupuncturist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Acupuncturist
- Fullerton, CA
- NPI 1609240811
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442966400000",
"number": "1407225113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "817 W WILSHIRE AVE",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928321649",
"telephone_number": "213-435-0665",
"fax_number": "714-449-1399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "817 W WILSHIRE AVE",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928321649",
"telephone_number": "213-435-0665",
"fax_number": "714-449-1399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOO",
"first_name": "JA HYUNG",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-23",
"last_updated": "2015-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "16434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.