Individual provider Active NPI

James Daehyun Kim, M.D.

  • Emergency Medicine Physician
  • Harbor City, CA
National Provider Identifier
1013363589
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R75578 Issued in AZ
Practice address
25825 Vermont Ave
Harbor City, CA 90710-3518
Phone
(310) 325-5111
NPI assigned
May 13, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R75578 AZ Primary

Addresses

Primary practice location

25825 Vermont Ave
Harbor City, CA 90710-3518

Mailing address

1501 N Campbell Ave
Tucson, AZ 85724-0001

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20181214001389 AZ Practitioner - Emergency Medicine 3678865318 Reassigns benefits to 1 organization
I20190816002107 TX Practitioner - Emergency Medicine 3678865318 Reassigns benefits to 1 organization
I20190822001447 CA Practitioner - Emergency MedicinePractitioner - Family Practice 3678865318 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
University of Pittsburgh School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

25821 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 325-5111

25825 Vermont Ave
Harbor City, CA 90710-3518
Phone (310) 325-5111

25965 Normandie Ave
Harbor City, CA 90710-3416
Phone (310) 325-5111

25975 Normandie Ave
Harbor City, CA 90710-3416
Phone (310) 257-6115

Hospital & facility affiliations

  • Kaiser Foundation Hospital - South Bay Hospital, Harbor City, CA, CCN 050411

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R75578AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Specialist Physicians Medical Associates, Inc Emergency Medicine CurrentSince Jun 15, 2019 Accepting new patients
Benson Hospital Corporation CurrentSince Nov 1, 2018 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Benson Hospital Corporation CurrentSince Nov 1, 2018 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Jul 1, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 14, 2019 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 14, 2019 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Jul 1, 2019 Accepting new patients

Locations

450 S Ocotillo St
Benson, AZ 85602
Phone (520) 586-2261

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

9333 Rosecrans Ave
Bellflower, CA 90706
Phone (562) 461-3340

9333 Imperial Hwy
Downey, CA 90242
Phone (562) 657-8850

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

4101 Torrance Blvd
Torrance, CA 90503
Phone (310) 540-7676

4401 W Memorial Rd
Ste 121
Oklahoma City, OK 73134
Phone (405) 749-4560

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 1

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": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1013363589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857240001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25825 VERMONT AVE",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907103518",
            "telephone_number": "310-325-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JAMES",
        "middle_name": "DAEHYUN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-13",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "R75578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9333 Imperial Hwy",
            "city": "Downey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902422812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harbor City, CA

Sources for this page

Verify at the official NPI Registry.