Active NPI
Timothy Yushin Kim
- Neurological Surgery Physician
- La Jolla, CA
National Provider Identifier
1023588324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- 9697
- Practice address
- 9300 Campus Point Dr
La Jolla, CA 92037-1300 - Phone
- (530) 574-5731
- NPI assigned
- Nov 29, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Neurological Surgery Physician | 207T00000X | 9697 | CA | Primary |
Addresses
Primary practice location
9300 Campus Point Dr
La Jolla, CA 92037-1300
Mailing address
8730 Costa Verde Blvd Apt 2302
San Diego, CA 92122-6638
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9697 | CA | MD | Neurological Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678320000000",
"number": "1023588324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8730 COSTA VERDE BLVD APT 2302",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921226638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9300 CAMPUS POINT DR",
"city": "LA JOLLA",
"state": "CA",
"postal_code": "920371300",
"telephone_number": "530-574-5731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "TIMOTHY",
"middle_name": "YUSHIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-29",
"last_updated": "2023-03-09",
"certification_date": "2023-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "CA",
"license": "9697",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Jolla, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.