Active NPI
Tae Su Kim
- Acupuncturist
- Compton, CA
National Provider Identifier
1821472994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC10617
- Practice address
- 2787 E del Amo Blvd
Compton, CA 90221-6005 - Phone
- (714) 244-0027
- NPI assigned
- Jul 17, 2015
- 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 | AC10617 | CA | Primary |
Addresses
Primary practice location
2787 E del Amo Blvd
Compton, CA 90221-6005
Mailing address
20909 Pioneer Blvd Apt 7
Lakewood, CA 90715-1363
Phone (714) 244-0027
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 |
|---|---|---|---|
| AC10617 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437091200000",
"number": "1821472994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20909 PIONEER BLVD APT 7",
"city": "LAKEWOOD",
"state": "CA",
"postal_code": "907151363",
"telephone_number": "714-244-0027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2787 E DEL AMO BLVD",
"city": "COMPTON",
"state": "CA",
"postal_code": "902216005",
"telephone_number": "714-244-0027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "TAE SU",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-17",
"last_updated": "2015-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC10617",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Compton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.