Active NPI
Jin Ho Bae, L.AC
- Acupuncturist
- Thousand Oaks, CA
National Provider Identifier
1609386408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 6059
- Practice address
- 650 E Thousand Oaks Blvd
Thousand Oaks, CA 91360-6009 - Phone
- (805) 497-7631
- Fax
- (888) 556-8420
- NPI assigned
- Oct 5, 2017
- Sex
- Male
- 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 | 6059 | CA | Primary |
Addresses
Primary practice location
650 E Thousand Oaks Blvd
Thousand Oaks, CA 91360-6009
Mailing address
650 E Thousand Oaks Blvd
Thousand Oaks, CA 91360-6009
Phone (805) 497-7631
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6059 | Other | CA | ACUPUNCTURE |
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 |
|---|---|---|---|
| 6059 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507161600000",
"number": "1609386408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 E THOUSAND OAKS BLVD",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913606009",
"telephone_number": "805-497-7631",
"fax_number": "888-556-8420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 E THOUSAND OAKS BLVD",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913606009",
"telephone_number": "805-497-7631",
"fax_number": "888-556-8420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAE",
"first_name": "JIN",
"middle_name": "HO",
"credential": "L.AC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-10-05",
"last_updated": "2017-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "6059",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACUPUNCTURE",
"identifier": "6059",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Thousand Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.