Individual provider Active NPI

Myung Jin Kang, ACUPUNCTURIST

  • Acupuncturist
  • Los Angeles, CA
National Provider Identifier
1790903748
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC1362 Issued in CA
Practice address
5250 Santa Monica Blvd
Suite #208
Los Angeles, CA 90029
Phone
(213) 380-7575
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC1362 CA Primary

Addresses

Primary practice location

5250 Santa Monica Blvd
Suite #208
Los Angeles, CA 90029

Mailing address

5250 Santa Monica Blvd
Suite #208
Los Angeles, CA 90029
Phone (213) 380-7575

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
AC1362CAMDAcupuncturist

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1790903748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 SANTA MONICA BLVD",
            "address_2": "SUITE #208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90029",
            "telephone_number": "213-380-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 SANTA MONICA BLVD",
            "address_2": "SUITE #208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90029",
            "telephone_number": "213-380-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANG",
        "first_name": "MYUNG",
        "middle_name": "JIN",
        "name_prefix": "Mr.",
        "credential": "ACUPUNCTURIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC1362",
            "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 Jun 30, 2015; 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.