Individual provider Active NPI

Min Sug Kim

  • Acupuncturist
  • Camarillo, CA
National Provider Identifier
1659699163
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC13466 Issued in CA
Practice address
697 Mobil Ave
Camarillo, CA 93010-6315
Phone
(805) 484-9013
Fax
(805) 484-9015
NPI assigned
May 7, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC13466 CA Primary

Addresses

Primary practice location

697 Mobil Ave
Camarillo, CA 93010-6315

Mailing address

697 Mobil Ave
Camarillo, CA 93010-6315
Phone (805) 484-9013

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
AC13466CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Ms Acupuncture Clinic Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1273190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294012800000",
    "number": "1659699163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "697 MOBIL AVE",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106315",
            "telephone_number": "805-484-9013",
            "fax_number": "805-484-9015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "697 MOBIL AVE",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930106315",
            "telephone_number": "805-484-9013",
            "fax_number": "805-484-9015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MIN SUG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-07",
        "last_updated": "2011-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC13466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2011; 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.