Active NPI
Jiwong Kim, L.AC
- Acupuncturist
- Irvine, CA
National Provider Identifier
1487056651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC15744
- Practice address
- 14785 Jeffrey Rd Ste 109
Irvine, CA 92618-0410 - Phone
- (714) 461-9160
- Fax
- (714) 461-9160
- NPI assigned
- Sep 19, 2014
- Sex
- Male
- Sole proprietor
- No
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 | AC15744 | CA | Primary |
Addresses
Primary practice location
14785 Jeffrey Rd Ste 109
Irvine, CA 92618-0410
Mailing address
14785 Jeffrey Rd Ste 109
Irvine, CA 92618-0410
Phone (714) 461-9160
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AC15744 | Other | CA | CALIFORNIA ACUPUNCTURE BOARD |
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 |
|---|---|---|---|
| AC15744 | CA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ebenezer Wellness Center, Inc. | 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.
-
- General Practice Physician
- Irvine, CA
- NPI 1114339272
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776038400000",
"number": "1487056651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14785 JEFFREY RD STE 109",
"city": "IRVINE",
"state": "CA",
"postal_code": "926180410",
"telephone_number": "714-461-9160",
"fax_number": "714-461-9160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14785 JEFFREY RD STE 109",
"city": "IRVINE",
"state": "CA",
"postal_code": "926180410",
"telephone_number": "714-461-9160",
"fax_number": "714-461-9160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JIWONG",
"credential": "L.AC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-19",
"last_updated": "2026-04-13",
"certification_date": "2026-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC15744",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA ACUPUNCTURE BOARD",
"identifier": "AC15744",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.