Individual provider Active NPI

Yang Taek Im, LA.C

  • Acupuncturist
  • Los Angeles, CA
National Provider Identifier
1780064238
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
LA.C 13284 Issued in CA
Practice address
2705 W 8TH St Ste B
Los Angeles, CA 90005-1286
Phone
(213) 800-4720
NPI assigned
May 31, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 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 LA.C 13284 CA Primary

Addresses

Primary practice location

2705 W 8TH St Ste B
Los Angeles, CA 90005-1286

Mailing address

798 3/4 S 4TH Ave
La Puente, CA 91746-2855
Phone (213) 800-4720

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
LA.C 13284CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1433030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1780064238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "798 3/4 S 4TH AVE",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917462855",
            "telephone_number": "213-800-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 W 8TH ST STE B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900051286",
            "telephone_number": "213-800-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IM",
        "first_name": "YANG TAEK",
        "credential": "LA.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-31",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "LA.C 13284",
            "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 29, 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.