Sang Bog Park, L,AC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC12201 Issued in CA

Practice address

50 Peninsula Ctr Ste D
Rolling Hills Estates, CA 90274-3563

Phone

(310) 541-7999

Fax

(310) 544-1969

NPI assigned

May 14, 2009

Last updated

May 14, 2009By the provider in NPPES

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Palos Verdes Oriental Medical Institute

  dba Palos Verdes Acupuncture & Wellness Center

  • Acupuncturist
  • Rolling Hills Estates, CA
  • NPI 1487714267
  NPD (past)

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

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242259200000",
    "number": "1952535270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 PENINSULA CTR STE D",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743563",
            "telephone_number": "310-541-7999",
            "fax_number": "310-544-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 PENINSULA CTR STE D",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743563",
            "telephone_number": "310-541-7999",
            "fax_number": "310-544-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "SANG BOG",
        "credential": "L,AC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-14",
        "last_updated": "2009-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC12201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle De Vela Padre, AGACNP-BC, AGCNS, RN
• Palos Verdes Family Vision
• Palos Verdes Oriental Medical Institute (Palos Verdes Acupuncture & Wellness Center)
• Palos Verdes Skin Surgery Center Inc.
• Palos Verdes Skin Surgery Ctr Inc (Palos Verdes Dermatology Surgery Center, Inc.)
• Patrick J. Stroh, D.D.S., M.S., Inc.
• Susan Wynn Paullin, M.D.
• Patricia Ingraham Paulsen, M.D.
• Theresa Ann Paulson, NURSE PRACTITIONER
• Peninsula Center for Children and Families

• Acupuncturist in Rolling Hills Estates, CA
• Providers in Rolling Hills Estates, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.

Verify at the official NPI Registry.