Andy Myungsoo Mo, L.AC, PH.D.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

11989 Issued in CA

Practice address

520 N Brookhurst St Ste 102
Anaheim, CA 92801-5207

Phone

(714) 312-5460

Fax

(714) 312-5460

NPI assigned

Sep 22, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Myungsoo Mo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Greenlife Acupuncture Inc

  • Acupuncturist
  • Anaheim, CA
  • NPI 1760934111
  NPD Authorized official

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1568612976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2616 BEACON ST",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353104",
            "telephone_number": "714-312-5460",
            "fax_number": "714-312-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N BROOKHURST ST STE 102",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928015207",
            "telephone_number": "714-312-5460",
            "fax_number": "714-312-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MO",
        "first_name": "ANDY",
        "middle_name": "MYUNGSOO",
        "name_prefix": "Dr.",
        "credential": "L.AC, PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-22",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "U01843",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "11989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYUNGSOO",
            "last_name": "MO",
            "prefix": "DR.",
            "credential": "L.AC, PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Neill S Mizoguchi, PHARMD
• Scott Mizufuka, MPT
• MJJ Homes, LLC
• Mla Health Services Inc
• MMP Enterprises Inc.
• Hongxia Mo
• Mobilitycare Transportation LLC
• Stephanie A Mock
• Amy Carlin Modglin
• Courtney Moeller, LMFT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.