Individual provider Active NPI

Cha Mi Kim, L. AC

  • Acupuncturist
  • Chino, CA
National Provider Identifier
1962583633
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC 9447 Issued in CA
Practice address
13801 Roswell Ave
Suite G
Chino, CA 91710-5466
Phone
(909) 548-6868
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC 9447 CA Primary

Addresses

Primary practice location

13801 Roswell Ave
Suite G
Chino, CA 91710-5466

Mailing address

6230 Brandy PL
Rancho Cucamonga, CA 91737-3896
Phone (909) 944-8054

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

LicenseStateTypeSpecialty
AC 9447CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Baek'S Chiropractic Health Center, Inc PastSince Sep 12, 2012 Accepting new patients
Baeks Chiropractic Health Center Acupuncturist Past Accepting new patients

Organizations & group practices 2

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962583633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6230 BRANDY PL",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917373896",
            "telephone_number": "909-944-8054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13801 ROSWELL AVE",
            "address_2": "SUITE G",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917105466",
            "telephone_number": "909-548-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHA",
        "middle_name": "MI",
        "name_prefix": "Dr.",
        "credential": "L. AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 9447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, 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.

Verify at the official NPI Registry.