Individual provider Active NPI

Bongkyun Francisco Suh, D.C, L.AC.

  • Acupuncturist
  • Los Angeles, CA
National Provider Identifier
1912937442
Registry record updated Feb 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC8688 Issued in CA
Practice address
4465 Wilshire Blvd Ste 303
Los Angeles, CA 90010-3716
Phone
(323) 936-4000
Fax
(323) 936-4001
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC8688 CA Primary
Chiropractor 111N00000X DC32983 CA

Addresses

Primary practice location

4465 Wilshire Blvd Ste 303
Los Angeles, CA 90010-3716

Mailing address

4465 Wilshire Blvd Ste 303
Los Angeles, CA 90010-3716
Phone (323) 936-4000

Other identifiers 2

IdentifierTypeStateIssuer
AC0086880MedicaidCA
DC32983MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140729000714 CA Practitioner - Chiropractic 3870719883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4465 Wilshire Blvd
Suite 303
Los Angeles, CA 90010-3716
Phone (323) 936-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC32983CAMDChiropractor
AC8688CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Acucenter of la, Inc Chiropractor CurrentSince Jun 18, 2014 Accepting new patients

Locations

4465 Wilshire Blvd
Ste 303
Los Angeles, CA 90010
Phone (323) 936-4000

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424044800000",
    "number": "1912937442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4465 WILSHIRE BLVD STE 303",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103716",
            "telephone_number": "323-936-4000",
            "fax_number": "323-936-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 WILSHIRE BLVD STE 303",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103716",
            "telephone_number": "323-936-4000",
            "fax_number": "323-936-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUH",
        "first_name": "BONGKYUN",
        "middle_name": "FRANCISCO",
        "name_prefix": "Dr.",
        "credential": "D.C, L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2015-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC8688",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC32983",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AC0086880",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DC32983",
            "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 Feb 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.