Active NPI
Tae Sun Kim, PHD
- Acupuncturist
- Anaheim, CA
National Provider Identifier
1508047192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC5880
- Practice address
- 866 S Harbor Blvd
Anaheim, CA 92805-5156 - Phone
- (714) 533-3370
- NPI assigned
- Nov 24, 2007
- Sex
- Female
- 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 | AC5880 | CA | Primary |
Addresses
Primary practice location
866 S Harbor Blvd
Anaheim, CA 92805-5156
Mailing address
866 S Harbor Blvd
Anaheim, CA 92805-5156
Phone (714) 533-3370
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AC5880 | CA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orange Senior Home Inc | Current | 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.
-
- Adult Care Home Facility
- Yorba Linda, CA
- NPI 1043184997
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195862400000",
"number": "1508047192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "866 S HARBOR BLVD",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928055156",
"telephone_number": "714-533-3370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "866 S HARBOR BLVD",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928055156",
"telephone_number": "714-533-3370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "TAE SUN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-24",
"last_updated": "2007-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC5880",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.