Individual provider Active NPI

Kim NG, M.D.

  • Hematology & Oncology Physician
  • Victorville, CA
National Provider Identifier
1003803685
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
A33989 Issued in CA
Practice address
12370 Hesperia Rd Ste 17
Victorville, CA 92395-5808
Phone
(760) 388-0071
Fax
(760) 513-9832
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A33989 CA
Medical Oncology Physician 207RX0202X MD60377608 WA
Hematology & Oncology Physician 207RH0003X A33989 CA Primary

Addresses

Primary practice location

12370 Hesperia Rd Ste 17
Victorville, CA 92395-5808

Mailing address

18000 Studebaker Rd Ste 800
Cerritos, CA 90703-2671
Phone (562) 735-3226

Other practice location 1

6501 Truxtun Ave
Bakersfield, CA 93309-0633
Phone (661) 322-2206

Other practice location 2

7360 W Deschutes Ave
Kennewick, WA 99336-7774
Phone (509) 473-0637

Other identifiers 1

IdentifierTypeStateIssuer
A33989OtherCALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050627000801 CA Practitioner - Hematology/Oncology 4688647860 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A33989CAMDSpecialist
MD60377608WAMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ravi Patel M.D. Inc Specialist CurrentSince Jul 1, 2005 Accepting new patients
Kern County Hospital Authority CurrentSince Jul 1, 2016 Accepting new patients
Kadlec Regional Medical Center Past Accepting new patients
MD Med Inc Past Accepting new patients
Casa Grande Community Hospital Past Accepting new patients
Bakersfield Memorial Hospital Past Accepting new patients
Providence Health & Services - Wa Past Accepting new patients

Locations

6501 Truxtun Ave
Bakersfield, CA 93309
Phone (661) 322-2206

1700 Mount Vernon Ave
Bakersfield, CA 93306
Phone (616) 326-2000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1003803685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18000 STUDEBAKER RD STE 800",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032671",
            "telephone_number": "562-735-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12370 HESPERIA RD STE 17",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955808",
            "telephone_number": "760-388-0071",
            "fax_number": "760-513-9832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6501 Truxtun Ave",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933090633",
            "country_code": "US",
            "telephone_number": "661-322-2206",
            "fax_number": "661-327-7027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7360 W Deschutes Ave",
            "address_purpose": "LOCATION",
            "city": "Kennewick",
            "state": "WA",
            "postal_code": "993367774",
            "country_code": "US",
            "telephone_number": "509-473-0637",
            "fax_number": "509-783-8244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NG",
        "first_name": "KIM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A33989",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "WA",
            "license": "MD60377608",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "A33989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A33989",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

Verify at the official NPI Registry.