Active NPI
Jeong Un Kim, PH. D.
- Acupuncturist
- Los Angeles, CA
National Provider Identifier
1447383401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC 9090
- Practice address
- 545 S Alvarado St
#B
Los Angeles, CA 90057-2903 - Phone
- (213) 483-5447
- NPI assigned
- Mar 13, 2007
- Last updated
- Jul 8, 2007
- 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 | AC 9090 | CA | Primary |
Addresses
Primary practice location
545 S Alvarado St
#B
Los Angeles, CA 90057-2903
Mailing address
535 S Alexandria Ave
Apt 225
Los Angeles, CA 90020-2860
Phone (213) 389-3153
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6134936 | Other | CA | MEDICAL PIN |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC 9090 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447383401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "535 S ALEXANDRIA AVE",
"address_2": "APT 225",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900202860",
"telephone_number": "213-389-3153",
"fax_number": "213-389-3153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "545 S ALVARADO ST",
"address_2": "#B",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900572903",
"telephone_number": "213-483-5447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JEONG",
"middle_name": "UN",
"name_prefix": "Dr.",
"credential": "PH. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC 9090",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL PIN",
"identifier": "6134936",
"state": "CA"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.