Individual provider Active NPI

Nam Sik Moon, L.AC

  • Acupuncturist
  • North Hollywood, CA
National Provider Identifier
1851640130
Registry record updated Sep 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC5301 Issued in CA
Practice address
10745 Riverside Dr
A
North Hollywood, CA 91602-2371
Phone
(818) 980-1105
NPI assigned
Sep 3, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 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 AC5301 CA Primary

Addresses

Primary practice location

10745 Riverside Dr
A
North Hollywood, CA 91602-2371

Mailing address

10745 Riverside Dr
A
North Hollywood, CA 91602-2371
Phone (818) 980-1105

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
AC5301CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1346630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346630400000",
    "number": "1851640130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10745 RIVERSIDE DR",
            "address_2": "A",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916022371",
            "telephone_number": "818-980-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10745 RIVERSIDE DR",
            "address_2": "A",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916022371",
            "telephone_number": "818-980-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "NAM",
        "middle_name": "SIK",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-03",
        "last_updated": "2012-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC5301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.