Active NPI
Kyung Sik Kim, LAC
- Acupuncturist
- Fremont, CA
National Provider Identifier
1902139934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 12534
- Practice address
- 3150 Southwycke Ter
Fremont, CA 94536-1960 - Phone
- (510) 386-2071
- NPI assigned
- Sep 9, 2009
- 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 | 12534 | CA | Primary |
Addresses
Primary practice location
3150 Southwycke Ter
Fremont, CA 94536-1960
Mailing address
3150 Southwycke Ter
Fremont, CA 94536-1960
Phone (510) 386-2071
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 |
|---|---|---|---|
| 12534 | CA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healing Acupuncture | Acupuncturist | Past | 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.
-
- Acupuncturist
- Fremont, CA
- NPI 1083965263
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252454400000",
"number": "1902139934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3150 SOUTHWYCKE TER",
"city": "FREMONT",
"state": "CA",
"postal_code": "945361960",
"telephone_number": "510-386-2071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3150 SOUTHWYCKE TER",
"city": "FREMONT",
"state": "CA",
"postal_code": "945361960",
"telephone_number": "510-386-2071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "KYUNG",
"middle_name": "SIK",
"name_prefix": "Mr.",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-09",
"last_updated": "2009-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "12534",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.