Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Blake Johnathan Broukhim, LAC

Individual provider Acupuncturist · NPI 1427921378

Blake Johnathan Broukhim, LAC is an Undefined Non-Physician Type (Specify) in North Hollywood, California. Qualified in 2025, 1 year ago. Practices as a sole proprietor and works from 3 locations. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2025
What do these letters mean?
LAC — Licensed Associate Counselor
A counsellor practising under supervision toward full licensure. In some states the same letters mean Licensed Acupuncturist.

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Practice location Address checks out

10614 Riverside Dr
North Hollywood, CA 91602-2373
Phone: (818) 755-6070
Fax: (818) 755-1870
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 9025 Wilshire Blvd Ste 300, Beverly Hills, CA 90211-1827 — (310) 786-2909
  • 1700 Westwood Blvd, Los Angeles, CA 90024-5608 — (310) 234-6600

Specialties & licences

Acupuncturist (primary) Taxonomy 171100000X · Licence AC20441 (CA)

Record details

NPI number1427921378
Entity typeIndividual (Type 1)
GenderMale
Credentials LAC
Sole proprietorYes
NPI enumeratedSeptember 26, 2025
Last updated in NPPESOctober 27, 2025
Certification dateOctober 27, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUNDEFINED NON-PHYSICIAN TYPE (SPECIFY)
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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