Jeong Min Park, L.AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC12582 Issued in CA

Practice address

1029 1/2 S Berendo St
Los Angeles, CA 90006-2603

Phone

(213) 388-1250

Fax

(213) 388-1350

NPI assigned

Oct 16, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rapha Acupuncture Healing Center Inc

  • Acupuncturist
  • Los Angeles, CA
  • NPI 1114198959
  NPD (past)

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289779200000",
    "number": "1629220074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 1/2 S BERENDO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062603",
            "telephone_number": "213-388-1250",
            "fax_number": "213-388-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 1/2 S BERENDO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062603",
            "telephone_number": "213-388-1250",
            "fax_number": "213-388-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "JEONG",
        "middle_name": "MIN",
        "name_prefix": "Miss",
        "credential": "L.AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-16",
        "last_updated": "2010-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC12582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Y. Park, MD
• Jee Won Park
• Jeffery S Park, LMFT 108456
• Jennifer Eun Kyong Park, MD
• Jenny Park
• Jeongyong Park
• Ji Won Park, CASE MANAGER
• Ji Young Park, PHARM.D
• Ji Young Park, L.AC.
• Jin Park, L.AC

• Acupuncturist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; 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.