Active NPI
Jaejoon Kim
- Acupuncturist
- Anaheim, CA
National Provider Identifier
1972055028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC17265
- Practice address
- 607 N Anaheim Blvd
Anaheim, CA 92805-2650 - Phone
- (213) 272-2125
- NPI assigned
- Oct 25, 2016
- Sex
- Male
- 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 | AC17265 | CA | Primary |
Addresses
Primary practice location
607 N Anaheim Blvd
Anaheim, CA 92805-2650
Mailing address
607 N Anaheim Blvd
Anaheim, CA 92805-2650
Phone (213) 272-2125
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 |
|---|---|---|---|
| AC17265 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477353600000",
"number": "1972055028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 N ANAHEIM BLVD",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928052650",
"telephone_number": "213-272-2125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "607 N ANAHEIM BLVD",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928052650",
"telephone_number": "213-272-2125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JAEJOON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-10-25",
"last_updated": "2016-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC17265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.