Individual provider Active NPI

Jung Sun Kim, L.AC.

  • Acupuncturist
  • Los Angeles, CA
National Provider Identifier
1457670655
Registry record updated Nov 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC13557 Issued in CA
Practice address
1029 1/2 S Berendo St
Los Angeles, CA 90006-2603
Phone
(213) 388-1250
Fax
(213) 388-1350
NPI assigned
May 27, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC13557 CA Primary

Addresses

Primary practice location

1029 1/2 S Berendo St
Los Angeles, CA 90006-2603

Mailing address

1029 1/2 S Berendo St
Los Angeles, CA 90006-2603
Phone (213) 388-1250

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

LicenseStateTypeSpecialty
AC13557CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Rapha Acupuncture Healing Center Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289606400000",
    "number": "1457670655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 1/2 S BERENDO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062603",
            "telephone_number": "213-388-1250",
            "fax_number": "213-388-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 1/2 S BERENDO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062603",
            "telephone_number": "213-388-1250",
            "fax_number": "213-388-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JUNG SUN",
        "name_prefix": "Mr.",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-27",
        "last_updated": "2010-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC13557",
            "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 Nov 13, 2010; 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.