Individual provider Active NPI

Kumiko Yamamoto, DAOM, L.AC,DIPL.O.M.

  • Acupuncturist
  • Los Angeles, CA
National Provider Identifier
1740410745
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC 13589 Issued in CA
Practice address
2001 S. Barrington Ave
Suite 305
Los Angeles, CA 90025
Phone
(310) 405-1610
Fax
(424) 325-6236
NPI assigned
Jul 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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 13589 CA Primary

Addresses

Primary practice location

2001 S. Barrington Ave
Suite 305
Los Angeles, CA 90025

Mailing address

2001 S. Barrington Ave
Suite 305
Los Angeles, CA 90025
Phone (310) 405-1610

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 13589CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Yingtcm, an Acupuncture Corporation Acupuncturist CurrentSince Dec 25, 2023 Accepting new patients
Yo San University of Traditional Chinese Medicine Acupuncturist Past Accepting new patients

Locations

2001 S Barrington Ave
Ste 305
Los Angeles, CA 90025
Phone (310) 405-1610

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1740410745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S. BARRINGTON AVE",
            "address_2": "SUITE 305",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90025",
            "telephone_number": "310-405-1610",
            "fax_number": "424-325-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S. BARRINGTON AVE",
            "address_2": "SUITE 305",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90025",
            "telephone_number": "310-405-1610",
            "fax_number": "424-325-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAMOTO",
        "first_name": "KUMIKO",
        "credential": "DAOM, L.AC,DIPL.O.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-24",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 13589",
            "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 Mar 3, 2022; 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.