Active NPI
Jihwon Im
- Acupuncturist
- Los Angeles, CA
National Provider Identifier
1477046787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 15600
- Practice address
- 4870 Santa Monica Blvd
Los Angeles, CA 90029-2634 - Phone
- (213) 804-0928
- NPI assigned
- Jun 11, 2018
- 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 | 15600 | CA | Primary |
Addresses
Primary practice location
4870 Santa Monica Blvd
Los Angeles, CA 90029-2634
Mailing address
415 S Berendo St Apt 109
Los Angeles, CA 90020-2165
Phone (213) 804-0928
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 |
|---|---|---|---|
| 15600 | CA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528675200000",
"number": "1477046787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 S BERENDO ST APT 109",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900202165",
"telephone_number": "213-804-0928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4870 SANTA MONICA BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900292634",
"telephone_number": "213-804-0928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IM",
"first_name": "JIHWON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-11",
"last_updated": "2018-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Acupuncturist",
"state": "CA",
"license": "15600",
"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 Jun 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.