NPI Record of EDDIE JOOHYUN MOON DAOM, L.AC. NPI 1003004946

Acupuncturist in Pasadena, CA

Complete NPI Record

Field Name Value Definition
NPI1003004946The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code1Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Last Name Legal NameMOONThe last name of the provider. If the provider is an individual, this is the legal name.
Provider First NameEDDIEThe first name of the provider, if the provider is an individual.
Provider Middle NameJOOHYUNThe middle name of the provider, if the provider is an individual.
Provider Credential TextDAOM, L.AC.The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Other Last NameMOONOther last name by which the provider being identified is or has been known.
Provider Other First NameJOO HYUNOther first name by which the provider being identified is or has been known (if an individual). This may be the same as the ‘‘Provider first name’’ if the provider is or has been known by a different last name only.
Provider Other Credential TextDAOM, L.AC.The other abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Other Last Name Type Code1Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address758 E COLORADO BLVDThe first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing AddressSTE.201The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City NamePASADENAThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameCAThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code911012127The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number2132683007The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address758 E COLORADO BLVDThe first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSTE.201The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NamePASADENAThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCAThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code911012127The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number2132683007The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date10/4/2007The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date3/19/2015The date that a record was last updated or changed.
Provider Gender CodeMThe code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1171100000XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1AC 11179The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1CAThe code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1Y
Is Sole ProprietorYCode indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No