Aiden Jakob Seraphim, AC18111

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC18111 Issued in CA

Practice address

2900 Bristol St Ste G203
Costa Mesa, CA 92626-7914

Phone

(978) 701-5125

NPI assigned

Sep 20, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1942551601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL ST STE G203",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267914",
            "telephone_number": "978-701-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL ST STE G203",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267914",
            "telephone_number": "978-701-5125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "819 SE Morrison St Ste 140",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972146309",
            "country_code": "US",
            "telephone_number": "503-740-4153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERAPHIM",
        "first_name": "AIDEN",
        "middle_name": "JAKOB",
        "name_prefix": "Mr.",
        "credential": "AC18111",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-20",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC18111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.