Active NPI
Won Moo Song, LAC
- Acupuncturist
- Van Nuys, CA
National Provider Identifier
1528119534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC 6705
- Practice address
- 17611 Sherman Way
Van Nuys, CA 91406-3510 - Phone
- (818) 343-7575
- Fax
- (818) 343-7272
- NPI assigned
- Jan 16, 2007
- 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 | AC 6705 | CA | Primary |
Addresses
Primary practice location
17611 Sherman Way
Van Nuys, CA 91406-3510
Mailing address
19705 Shadow Glen Cir
Northridge, CA 91326-3840
Phone (818) 590-4697
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 |
|---|---|---|---|
| AC 6705 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528119534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19705 SHADOW GLEN CIR",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913263840",
"telephone_number": "818-590-4697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17611 SHERMAN WAY",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914063510",
"telephone_number": "818-343-7575",
"fax_number": "818-343-7272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "WON",
"middle_name": "MOO",
"name_prefix": "Mr.",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC 6705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.