Individual provider Active NPI

Daniel Kwangkyum Kim, L.AC

  • Acupuncturist
  • Westlake Village, CA
National Provider Identifier
1851789200
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC13899 Issued in CA
Practice address
699 Hampshire Rd Ste 108
Westlake Village, CA 91361-2352
Phone
(805) 379-4747
NPI assigned
Jan 7, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC13899 CA Primary

Addresses

Primary practice location

699 Hampshire Rd Ste 108
Westlake Village, CA 91361-2352

Mailing address

1510 Plumeria Cir
Thousand Oaks, CA 91360-6329
Phone (805) 657-4492

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
AC13899CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Root Acupuncture Clinic. Inc Acupuncturist PastSince Oct 27, 2024 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1851789200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 PLUMERIA CIR",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913606329",
            "telephone_number": "805-657-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 HAMPSHIRE RD STE 108",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913612352",
            "telephone_number": "805-379-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DANIEL",
        "middle_name": "KWANGKYUM",
        "credential": "L.AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-07",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC13899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.