KSJ Acupuncture Clinic, Inc.

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

KSJ ACUPUNCTURE CLINIC, INC.

Practice address

12402 Industrial Blvd Ste B2
Victorville, CA 92395-5889

Phone

(760) 428-2800

Fax

(657) 255-4049

NPI assigned

Jun 25, 2019

Last updated

Jun 25, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sang Jo Kim, DAOM, L.AC.NPI 1902013741

Title

C.E.O.

Phone

(760) 428-2800

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sang Jo Kim, L.AC.

  • Acupuncturist
  • Victorville, CA
  • NPI 1902013741
  NPD Authorized official

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

{
    "created_epoch": "1561420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561420800000",
    "number": "1922669456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 CHEYENNE WAY UNIT 177",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928334939",
            "telephone_number": "760-428-2800",
            "fax_number": "657-255-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12402 INDUSTRIAL BLVD STE B2",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955889",
            "telephone_number": "760-428-2800",
            "fax_number": "657-255-4049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KSJ ACUPUNCTURE CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-25",
        "last_updated": "2019-06-25",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SANG JO",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "760-428-2800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DAOM, L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUPUNCTURE LICENSE",
            "identifier": "AC8143",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheila Marie Kraft, NP
• Krishna Das MD Inc.
• Johan Jacob Kritzinger, DDS
• Jeremiah J Kroeker, BC-PMHNP
• KSJ Acupuncture Clinic
• Crystal Kudrle
• Prashanth Vasantha Kumar, M.D.
• Ritesh Kumar, DDS
• Roberta Nolan Kunath, VN
• Trenisha Kunzi

• Acupuncturist in Victorville, CA
• Providers in Victorville, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; 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.