Kevin Wing Yim, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17695 Issued in CA

Practice address

16455 Main St.
Hesperia, CA 92345-3500

Phone

(760) 947-2161

Fax

(760) 947-3673

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334275200000",
    "number": "1013001213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 CARNEGIE DR",
            "address_2": "STE. 230",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083583",
            "telephone_number": "909-890-0407",
            "fax_number": "909-890-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16455 MAIN ST.",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923453500",
            "telephone_number": "760-947-2161",
            "fax_number": "760-947-3673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YIM",
        "first_name": "KEVIN",
        "middle_name": "WING",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2012-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Hesperia, CA
• Providers in Hesperia, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; 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.