Active NPI
Junghee Jason Kim, L.AC
- Acupuncturist
- Garden Grove, CA
National Provider Identifier
1497904601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 12178
- Practice address
- 14104 Brookhurst St
Garden Grove, CA 92843-4604 - Phone
- (714) 636-3886
- Fax
- (714) 636-3459
- NPI assigned
- Sep 11, 2008
- 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 | 12178 | CA | Primary |
Addresses
Primary practice location
14104 Brookhurst St
Garden Grove, CA 92843-4604
Mailing address
14104 Brookhurst St
Garden Grove, CA 92843-4604
Phone (714) 636-3886
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 |
|---|---|---|---|
| 12178 | CA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MK Health Center | 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.
-
- Health Maintenance Organization
- Garden Grove, CA
- NPI 1396005476
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339372800000",
"number": "1497904601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14104 BROOKHURST ST",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928434604",
"telephone_number": "714-636-3886",
"fax_number": "714-636-3459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14104 BROOKHURST ST",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928434604",
"telephone_number": "714-636-3886",
"fax_number": "714-636-3459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JUNGHEE",
"middle_name": "JASON",
"credential": "L.AC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-11",
"last_updated": "2012-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "12178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.