Individual provider Active NPI

Jooyong Shin, LAC

  • Acupuncturist
  • Los Angeles, CA
National Provider Identifier
1962931246
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC17500 Issued in CA
Practice address
400 S Western Ave #203
Los Angeles, CA 90005
Phone
(213) 505-8588
NPI assigned
Jun 8, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC17500 CA Primary

Addresses

Primary practice location

400 S Western Ave #203
Los Angeles, CA 90005

Mailing address

400 S Western Ave # 203
Los Angeles, CA 90020-4103
Phone (213) 505-8588

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
AC17500CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Are-a Acupuncture, Inc. Acupuncturist PastSince Jul 24, 2022 Accepting new patients
Are-a Acupuncture.Inc. Acupuncturist PastSince Jul 24, 2022 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": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1962931246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S WESTERN AVE # 203",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900204103",
            "telephone_number": "213-505-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S WESTERN AVE #203",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90005",
            "telephone_number": "213-505-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "JOOYONG",
        "name_prefix": "Mrs.",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC17500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.