Individual provider Active NPI

Steven Woong Kim, MD

  • Hematology & Oncology Physician
  • Fullerton, CA
National Provider Identifier
1003886698
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
C52751 Issued in CA
Practice address
2151 N Harbor Blvd Ste 3200
Fullerton, CA 92835-3826
Phone
(714) 446-5900
Fax
(714) 446-5800
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 200000491 NC
Hematology & Oncology Physician 207RH0003X C52751 CA Primary

Addresses

Primary practice location

2151 N Harbor Blvd Ste 3200
Fullerton, CA 92835-3826

Mailing address

2151 N Harbor Blvd Ste 3200
Fullerton, CA 92835-3826
Phone (714) 446-5900

Other practice location 1

15855 Pomona Rincon Rd Bldg 4
Chino Hills, CA 91709-3162
Phone (714) 446-5900

Other identifiers 2

IdentifierTypeStateIssuer
006018491MedicaidVA
89126K7MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stevenwkim@sjhhandhmg.allscriptsdirect.net

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
I20080122000852 CA Practitioner - Hematology/Oncology 5991744732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Baylor College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

15855 Pomona Rincon Rd
BLDG 4
Chino Hills, CA 91709-3162
Phone (909) 929-2511

Hospital & facility affiliations

  • Providence St. Jude Medical Center Hospital, Fullerton, CA, CCN 050168

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C52751CAMDHematology & Oncology Physician
200000491NCMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Oct 4, 2010 Accepting new patients
Providence Medical Foundation CurrentSince Oct 4, 2010 Accepting new patients
Providence Medical Foundation Current Accepting new patients
St Jude Hospital Inc Past Accepting new patients
Prime Healthcare Services - Montclair, LLC Past Accepting new patients
Pomona Valley Hospital Medical Center Past Accepting new patients
Uhs Corona Inc Past Accepting new patients
San Antonio Regional Hospital Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

19333 Bear Valley Rd
Ste 106
Apple Valley, CA 92308
Phone (760) 240-5505

15855 Pomona Rincon Rd
Bldg 4
Chino Hills, CA 91709
Phone (714) 626-8630

1514 Valley Vista Dr
Diamond Bar, CA 91765
Phone (909) 560-1144

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

2151 N Harbor Blvd
Ste 3200
Fullerton, CA 92835
Phone (714) 446-5101

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1003886698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 N HARBOR BLVD STE 3200",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353826",
            "telephone_number": "714-446-5900",
            "fax_number": "714-446-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 N HARBOR BLVD STE 3200",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353826",
            "telephone_number": "714-446-5900",
            "fax_number": "714-446-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15855 Pomona Rincon Rd Bldg 4",
            "address_purpose": "LOCATION",
            "city": "Chino Hills",
            "state": "CA",
            "postal_code": "917093162",
            "country_code": "US",
            "telephone_number": "714-446-5900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "STEVEN",
        "middle_name": "WOONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "200000491",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "CA",
            "license": "C52751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006018491",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89126K7",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stevenwkim@sjhhandhmg.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "2151 N Harbor Blvd Ste 3200",
            "city": "Fullerton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928353826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.