Individual provider Active NPI

Issac Kim, LAC

  • Acupuncturist
  • Los Angeles, CA
National Provider Identifier
1659555068
Registry record updated Mar 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC11862 Issued in CA
Practice address
2120 W 8TH St Ste 210
Los Angeles, CA 90057-4081
Phone
(213) 386-4517
Fax
(213) 386-0021
NPI assigned
Dec 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC11862 CA Primary

Addresses

Primary practice location

2120 W 8TH St Ste 210
Los Angeles, CA 90057-4081

Mailing address

756 S Kingsley Dr
Los Angeles, CA 90005

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

LicenseStateTypeSpecialty
AC11862CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520812800000",
    "number": "1659555068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "756 S KINGSLEY DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 W 8TH ST STE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900574081",
            "telephone_number": "213-386-4517",
            "fax_number": "213-386-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ISSAC",
        "name_prefix": "Mr.",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-20",
        "last_updated": "2018-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC11862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2018; 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.