Individual provider Active NPI

Deok Hee Ahn, LAC.

  • Acupuncturist
  • San Marino, CA
National Provider Identifier
1467656165
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
11129 Issued in CA
Practice address
2343 Huntington Dr
San Marino, CA 91108
Phone
(626) 590-5577
Fax
(626) 463-1263
NPI assigned
Jun 14, 2007
Last updated
Jul 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 11129 CA Primary

Addresses

Primary practice location

2343 Huntington Dr
San Marino, CA 91108

Mailing address

2343 Huntington Dr
San Marino, CA 91108-2642
Phone (626) 590-5577

Other practice location 1

822 S Robertson Blvd
105
Los Angeles, CA 90035-1613
Phone (310) 854-7788

Other practice location 2

768 Linda Vista Ave
Pasadena, CA 91103-2769
Phone (626) 590-5577

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
11129CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1467656165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2343 HUNTINGTON DR",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911082642",
            "telephone_number": "626-590-5577",
            "fax_number": "626-463-1263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2343 HUNTINGTON DR",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "91108",
            "telephone_number": "626-590-5577",
            "fax_number": "626-463-1263"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "822 S Robertson Blvd",
            "address_2": "105",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900351613",
            "country_code": "US",
            "telephone_number": "310-854-7788",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "768 Linda Vista Ave",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911032769",
            "country_code": "US",
            "telephone_number": "626-590-5577",
            "fax_number": "626-463-1263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHN",
        "first_name": "DEOK",
        "middle_name": "HEE",
        "name_prefix": "Mrs.",
        "credential": "LAC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "11129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2018; 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.