Active NPI
Keewoon Song, L.AC
- Acupuncturist
- Los Angeles, CA
National Provider Identifier
1740585751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC6048
- Practice address
- 3337 W Olympic Blvd
Los Angeles, CA 90019-2321 - Phone
- (323) 730-8890
- Fax
- (323) 730-8890
- NPI assigned
- Jan 22, 2011
- 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 | AC6048 | CA | Primary |
Addresses
Primary practice location
3337 W Olympic Blvd
Los Angeles, CA 90019-2321
Mailing address
3337 W Olympic Blvd
Los Angeles, CA 90019-2321
Phone (323) 730-8890
Other practice location 1
3341A W Olympic Blvd
Los Angeles, CA 90019-2321
Phone (323) 730-8890
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 |
|---|---|---|---|
| AC6048 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569369600000",
"number": "1740585751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3337 W OLYMPIC BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900192321",
"telephone_number": "323-730-8890",
"fax_number": "323-730-8890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3337 W OLYMPIC BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900192321",
"telephone_number": "323-730-8890",
"fax_number": "323-730-8890"
}
],
"practiceLocations": [
{
"address_1": "3341A W Olympic Blvd",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900192321",
"country_code": "US",
"telephone_number": "323-730-8890",
"fax_number": "323-730-8890",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SONG",
"first_name": "KEEWOON",
"name_prefix": "Mr.",
"credential": "L.AC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-22",
"last_updated": "2019-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC6048",
"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 Sep 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.