Sangsik Jin, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC13672 Issued in CA

Practice address

15901 Hawthorne Blvd Ste 115
Lawndale, CA 90260-2766

Phone

(310) 701-1077

NPI assigned

Oct 14, 2011

Reactivated

Jan 25, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Manhattan Wellness Ctr Inc

  • Acupuncturist
  • Lawndale, CA
  • NPI 1164147542
  NPD Authorized official
• Uri Inc

  • Acupuncturist
  • Harbor City, CA
  • NPI 1013299445
  NPD (past) Authorized official
• Uri, Inc.

  • Acupuncturist
  • Harbor City, CA
  • NPI 1912283383
  NPD (past) Authorized official

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

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1477838068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15901 HAWTHORNE BLVD STE 115",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902602766",
            "telephone_number": "310-701-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15901 HAWTHORNE BLVD STE 115",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902602766",
            "telephone_number": "310-701-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIN",
        "first_name": "SANGSIK",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-14",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "deactivation_date": "2022-10-07",
        "reactivation_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC13672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUPUNCTURE",
            "identifier": "AC13672",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marisa Jantzen
• Jason H. Ta, DMD, Inc.
• Jehovah-Jireh Medical Supplies Inc.
• Jerry a Okonkwoaguolu MD
• Laura Lonwah Jin
• Jodi L. Clark O.D.
• Robert T Johnson, MASSAGE LICENSE
• Autumn Jones
• Brenda Jordan
• Jourabchi Dental Inc

• Acupuncturist in Lawndale, CA
• Providers in Lawndale, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.