Active NPI
Susan Kim, L.AC.
- Acupuncturist
- Culver City, CA
National Provider Identifier
1568989556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 15155
- Practice address
- 11204 Braddock Dr
Culver City, CA 90230-4807 - Phone
- (310) 985-0554
- NPI assigned
- Aug 29, 2017
- Last updated
- Aug 29, 2017
- Sex
- Female
- 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 | 15155 | CA | Primary |
Addresses
Primary practice location
11204 Braddock Dr
Culver City, CA 90230-4807
Mailing address
28081 Ella Rd
Rancho Palos Verdes, CA 90275-3213
Phone (310) 926-0646
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Coast Community Acupuncture | Acupuncturist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Acupuncturist
- Culver City, CA
- NPI 1497272223
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503964800000",
"number": "1568989556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28081 ELLA RD",
"city": "RANCHO PALOS VERDES",
"state": "CA",
"postal_code": "902753213",
"telephone_number": "310-926-0646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11204 BRADDOCK DR",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902304807",
"telephone_number": "310-985-0554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SUSAN",
"credential": "L.AC.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-29",
"last_updated": "2017-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "15155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.