Peter C Kim DPM Inc

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E4027 Issued in CA

Legal business name

PETER C KIM DPM INC

Practice address

4482 Barranca Pkwy Ste 228
Irvine, CA 92604-1738

Phone

(949) 379-3080

Fax

(949) 379-3020

NPI assigned

Oct 5, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Peter Chang Kim, DPMNPI 1053340687

Title

President

Phone

(949) 379-3080

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Irvine Foot & Ankle Care Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Chang Kim, DPM

  • Primary Podiatric Medicine Podiatrist
  • Irvine, CA
  • NPI 1053340687
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696291200000",
    "number": "1003168626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4482 BARRANCA PKWY STE 228",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926041738",
            "telephone_number": "949-379-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4482 BARRANCA PKWY STE 228",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926041738",
            "telephone_number": "949-379-3080",
            "fax_number": "949-379-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER C KIM DPM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-05",
        "last_updated": "2023-10-03",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "CHANG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-379-3080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4027",
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E40272",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "62ifac@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4482 Barranca Pkwy Ste 228",
            "city": "Irvine",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926041738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Irvine Foot & Ankle Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Irvine Foot & Ankle Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Foot & Ankle Surgery Podiatrist in Irvine, CA
• Providers in Irvine, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.