Individual provider Active NPI

Hyun Jin Ko, L.AC.

  • Acupuncturist
  • Garden Grove, CA
National Provider Identifier
1700949799
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC8432 Issued in CA
Practice address
9535 Garden Grove Blvd Ste 103
Garden Grove, CA 92844-1551
Phone
(714) 534-1113
Fax
(714) 534-1116
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC8432 CA Primary

Addresses

Primary practice location

9535 Garden Grove Blvd Ste 103
Garden Grove, CA 92844-1551

Mailing address

16202 Eagleridge CT
La Mirada, CA 90638-6505
Phone (714) 402-2054

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
AC8432CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700949799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16202 EAGLERIDGE CT",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906386505",
            "telephone_number": "714-402-2054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9535 GARDEN GROVE BLVD STE 103",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441551",
            "telephone_number": "714-534-1113",
            "fax_number": "714-534-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "HYUN",
        "middle_name": "JIN",
        "name_prefix": "Mr.",
        "credential": "L.AC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC8432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, 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.

Verify at the official NPI Registry.