Individual provider Active NPI

Jin Woo Moon, D.C.

  • Chiropractor
  • Anaheim, CA
National Provider Identifier
1740486356
Registry record updated Feb 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC28135 Issued in CA
Practice address
137 S Knott Ave
Anaheim, CA 92804-1406
Phone
(714) 484-9000
NPI assigned
Jun 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC28135 CA Primary

Addresses

Primary practice location

137 S Knott Ave
Anaheim, CA 92804-1406

Mailing address

137 S Knott Ave
Anaheim, CA 92804-1406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050420000742 CA Practitioner - Chiropractic 7113965104 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28135CAMDPsychologist
DC28135CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Jin Moon Chiropractic Group, Inc. Chiropractor CurrentSince Nov 1, 2008 Accepting new patients

Locations

6888 Lincoln Ave
Ste C
Buena Park, CA 90620
Phone (714) 484-9000

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.

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234137600000",
    "number": "1740486356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 S KNOTT AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928041406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 S KNOTT AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928041406",
            "telephone_number": "714-484-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "JIN",
        "middle_name": "WOO",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2009-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC28135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.