Individual provider Active NPI

Koji Ichihashi, L.AC.

  • Acupuncturist
  • Menlo Park, CA
National Provider Identifier
1699947762
Registry record updated Mar 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC 1357 Issued in CA
Practice address
845 El Camino Real
Menlo Park, CA 94025-4807
Phone
(415) 497-0751
NPI assigned
Mar 29, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC 1357 CA Primary

Addresses

Primary practice location

845 El Camino Real
Menlo Park, CA 94025-4807

Mailing address

30 Via Holon Apt 5
Greenbrae, CA 94904-1913
Phone (415) 497-0751

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
AC 1357CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1206748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206748800000",
    "number": "1699947762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 VIA HOLON APT 5",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949041913",
            "telephone_number": "415-497-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 EL CAMINO REAL",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254807",
            "telephone_number": "415-497-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICHIHASHI",
        "first_name": "KOJI",
        "name_prefix": "Mr.",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-29",
        "last_updated": "2008-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 1357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2008; 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.