Individual provider Active NPI

Moon J. Shin, L.AC.

  • Acupuncturist
  • Redwood City, CA
National Provider Identifier
1972682417
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC9924 Issued in CA
Practice address
950 Woodside Rd
Suite 4
Redwood City, CA 94061-5634
Phone
(650) 556-1143
Fax
(650) 556-0053
NPI assigned
Nov 3, 2006
Sex
Male
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 AC9924 CA Primary

Addresses

Primary practice location

950 Woodside Rd
Suite 4
Redwood City, CA 94061-5634

Mailing address

950 Woodside Rd
Suite 4
Redwood City, CA 94061-5634
Phone (650) 556-1143

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
AC9924CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972682417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 WOODSIDE RD",
            "address_2": "SUITE 4",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940615634",
            "telephone_number": "650-556-1143",
            "fax_number": "650-556-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 WOODSIDE RD",
            "address_2": "SUITE 4",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940615634",
            "telephone_number": "650-556-1143",
            "fax_number": "650-556-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "MOON",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC9924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, 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.