Active NPI
Irit Potter, MSOM, L.AC.
- Acupuncturist
- San Marino, CA
National Provider Identifier
1942359104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 5258
- Practice address
- 375 Huntington Dr Ste C
San Marino, CA 91108-2357 - Phone
- (626) 441-9908
- Fax
- (626) 441-9909
- NPI assigned
- Jan 9, 2007
- Sex
- Female
- 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 | 5258 | CA | Primary |
Addresses
Primary practice location
375 Huntington Dr Ste C
San Marino, CA 91108-2357
Mailing address
375 Huntington Dr Ste C
San Marino, CA 91108-2357
Phone (626) 441-9908
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 |
|---|---|---|---|
| 5258 | CA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942359104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375 HUNTINGTON DR STE C",
"city": "SAN MARINO",
"state": "CA",
"postal_code": "911082357",
"telephone_number": "626-441-9908",
"fax_number": "626-441-9909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 HUNTINGTON DR STE C",
"city": "SAN MARINO",
"state": "CA",
"postal_code": "911082357",
"telephone_number": "626-441-9908",
"fax_number": "626-441-9909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "IRIT",
"name_prefix": "Mrs.",
"credential": "MSOM, L.AC.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "5258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Marino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.