Individual provider Active NPI

Chong Yub Kim, LAC

  • Acupuncturist
  • Torrance, CA
National Provider Identifier
1982941209
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC14694 Issued in CA
Practice address
2772 Sepulveda Blvd
#28
Torrance, CA 90505-2952
Phone
(310) 220-4314
NPI assigned
Jan 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC14694 CA Primary

Addresses

Primary practice location

2772 Sepulveda Blvd
#28
Torrance, CA 90505-2952

Mailing address

2772 Sepulveda Blvd
#28
Torrance, CA 90505-2952
Phone (310) 220-4314

Other identifiers 1

IdentifierTypeStateIssuer
AC14694MedicaidCA

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
AC14694CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Energy Acupuncture Acupuncturist Past Accepting new patients
Energy Acupuncture 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": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1982941209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2772 SEPULVEDA BLVD",
            "address_2": "#28",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905052952",
            "telephone_number": "310-220-4314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2772 SEPULVEDA BLVD",
            "address_2": "#28",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905052952",
            "telephone_number": "310-220-4314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHONG",
        "middle_name": "YUB",
        "name_prefix": "Mr.",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC14694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AC14694",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; 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.