Individual provider Active NPI

Yoo Kyong Kim, L.AC.

  • Acupuncturist
  • Fullerton, CA
National Provider Identifier
1689217770
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC18706 Issued in CA
Practice address
301 W Bastanchury Rd Ste 5
Fullerton, CA 92835-3422
Phone
(949) 309-7717
NPI assigned
Oct 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC18706 CA Primary

Addresses

Primary practice location

301 W Bastanchury Rd Ste 5
Fullerton, CA 92835-3422

Mailing address

1584 Avenida Selva
Fullerton, CA 92833-1553
Phone (949) 309-7717

Other practice location 1

2691 Richter Ave Ste 120
Irvine, CA 92606-5124
Phone (949) 309-7717

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
AC18706CAMDAcupuncturist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1689217770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1584 AVENIDA SELVA",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928331553",
            "telephone_number": "949-309-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD STE 5",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353422",
            "telephone_number": "949-309-7717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2691 Richter Ave Ste 120",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926065124",
            "country_code": "US",
            "telephone_number": "949-309-7717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "YOO KYONG",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-22",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC18706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.