Active NPI
Daniel Kim, M.D.
- Diagnostic Radiology Physician
- Simi Valley, CA
National Provider Identifier
1013968957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- A29336
- Practice address
- 2975 Sycamore Dr
Simi Valley, CA 93065-1201 - Phone
- (805) 527-2462
- NPI assigned
- May 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | A29336 | CA | Primary |
Addresses
Primary practice location
2975 Sycamore Dr
Simi Valley, CA 93065-1201
Mailing address
PO Box 190
Simi Valley, CA 93062-0190
Phone (805) 522-5940
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A293360 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A29336 | CA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rad Alliance, Inc. | Past | Accepting new patients | |
| Renaissance Imaging Medical Associates, Inc. | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Specialist
- Los Angeles, CA
- NPI 1184810277
-
- Diagnostic Radiology Physician
- Northridge, CA
- NPI 1487608931
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201824000000",
"number": "1013968957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 190",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930620190",
"telephone_number": "805-522-5940",
"fax_number": "805-522-6401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2975 SYCAMORE DR",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930651201",
"telephone_number": "805-527-2462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "DANIEL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-15",
"last_updated": "2008-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "A29336",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A293360",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Simi Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.