John J Kim MD Inc

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

A29493 Issued in CA

Legal business name

JOHN J KIM MD INC

Practice address

629 N 13TH Ave
Upland, CA 91786-4906

Phone

(909) 981-8905

Fax

(909) 982-8051

NPI assigned

Jun 4, 2007

Last updated

Jun 27, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John J. Kim, M.D.NPI 1548218274

Title

President

Phone

(909) 981-8905

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John J Kim, M.D.

  • Gastroenterology Physician
  • Upland, CA
  • NPI 1548218274
  Authorized official Same address or phone

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466985600000",
    "number": "1003018755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 N 13TH AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864906",
            "telephone_number": "909-981-8905",
            "fax_number": "909-982-8051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 N 13TH AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864906",
            "telephone_number": "909-981-8905",
            "fax_number": "909-982-8051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN J KIM MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2016-06-27",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-981-8905",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A29493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Upland, CA
• Providers in Upland, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.

Verify at the official NPI Registry.