Active NPI
Kyong Keun Kwak, ACCUPUNCTURIST
- Acupuncturist
- Sacramento, CA
National Provider Identifier
1699837930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC5461
- Practice address
- 10063 Folsom Blvd
Suite D
Sacramento, CA 95827-1434 - Phone
- (916) 361-7870
- Fax
- (916) 361-7870
- NPI assigned
- Dec 14, 2006
- 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 | AC5461 | CA | Primary |
Addresses
Primary practice location
10063 Folsom Blvd
Suite D
Sacramento, CA 95827-1434
Mailing address
10063 Folsom Blvd
Suite D
Sacramento, CA 95827-1434
Phone (916) 361-7870
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 |
|---|---|---|---|
| AC5461 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699837930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10063 FOLSOM BLVD",
"address_2": "SUITE D",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958271434",
"telephone_number": "916-361-7870",
"fax_number": "916-361-7870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10063 FOLSOM BLVD",
"address_2": "SUITE D",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958271434",
"telephone_number": "916-361-7870",
"fax_number": "916-361-7870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWAK",
"first_name": "KYONG",
"middle_name": "KEUN",
"credential": "ACCUPUNCTURIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC5461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.