Individual provider Active NPI

Ki H Kim, M.S., L.AC.

  • Acupuncturist
  • Los Angeles, CA
National Provider Identifier
1851433882
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC11034 Issued in CA
Practice address
3020 Wilshire Blvd Ste 220
Los Angeles, CA 90010-1120
Phone
(213) 924-6079
Fax
(844) 734-0427
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC11034 CA Primary

Addresses

Primary practice location

3020 Wilshire Blvd Ste 220
Los Angeles, CA 90010-1120

Mailing address

3020 Wilshire Blvd Ste 220
Los Angeles, CA 90010-1120
Phone (213) 924-6079

Other identifiers 1

IdentifierTypeStateIssuer
212799962MedicaidCA

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
Master of Science

State licenses

LicenseStateTypeSpecialty
AC11034CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1851433882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 WILSHIRE BLVD STE 220",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101120",
            "telephone_number": "213-924-6079",
            "fax_number": "844-734-0427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 WILSHIRE BLVD STE 220",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101120",
            "telephone_number": "213-924-6079",
            "fax_number": "844-734-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KI",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "M.S., L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC11034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212799962",
            "state": "CA"
        }
    ],
    "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 Apr 5, 2018; 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.