Active NPI
Kitak Kim, L.AC
- Acupuncturist
- Los Angeles, CA
National Provider Identifier
1710324843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC13583
- Practice address
- 3030 W. Olympic Blvd
Suite 211
Los Angeles, CA 90006-6509 - Phone
- (213) 703-6939
- Fax
- (213) 210-2231
- NPI assigned
- May 30, 2013
- 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 | AC13583 | CA | Primary |
Addresses
Primary practice location
3030 W. Olympic Blvd
Suite 211
Los Angeles, CA 90006-6509
Mailing address
719 S Gramercy PL
Los Angeles, CA 90005-3166
Phone (213) 703-6939
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 |
|---|---|---|---|
| AC13583 | CA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Acukt Corporation | Acupuncturist | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
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.
-
- Acupuncturist
- Los Angeles, CA
- NPI 1932845187
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386720000000",
"number": "1710324843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "719 S GRAMERCY PL",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900053166",
"telephone_number": "213-703-6939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3030 W. OLYMPIC BLVD",
"address_2": "SUITE 211",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900066509",
"telephone_number": "213-703-6939",
"fax_number": "213-210-2231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "KITAK",
"name_prefix": "Mr.",
"credential": "L.AC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-30",
"last_updated": "2013-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC13583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.