Individual provider Active NPI

Daniel Sang Nam, L.AC., PHD.

  • Acupuncturist
  • Lake Elsinore, CA
National Provider Identifier
1841563731
Registry record updated Sep 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
L.AC. 5993 Issued in CA
Practice address
32245 Mission TRL
Suite D6
Lake Elsinore, CA 92530-4528
Phone
(951) 674-8683
NPI assigned
Feb 23, 2012
Last updated
Sep 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X L.AC. 5993 CA Primary

Addresses

Primary practice location

32245 Mission TRL
Suite D6
Lake Elsinore, CA 92530-4528

Mailing address

15069 Heather LN
Lake Elsinore, CA 92530-5260
Phone (951) 674-0194

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
L.AC. 5993CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
West Coast Chiropractic Inc Past Accepting new patients
Union Acupuncture Clinic Acupuncturist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348963200000",
    "number": "1841563731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15069 HEATHER LN",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925305260",
            "telephone_number": "951-674-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32245 MISSION TRL",
            "address_2": "SUITE D6",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304528",
            "telephone_number": "951-674-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAM",
        "first_name": "DANIEL",
        "middle_name": "SANG",
        "name_prefix": "Dr.",
        "credential": "L.AC., PHD.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-23",
        "last_updated": "2012-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "L.AC. 5993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2012; 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.