Individual provider Active NPI

Alexander Kim, DNP

  • Primary Care Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1033618509
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
95008286 Issued in CA
Practice address
701 W Cesar E Chavez Ave Ste 201
Los Angeles, CA 90012-2185
Phone
(213) 217-5300
NPI assigned
Feb 9, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 95008286 CA Primary

Addresses

Primary practice location

701 W Cesar E Chavez Ave Ste 201
Los Angeles, CA 90012-2185

Mailing address

701 W Cesar E Chavez Ave Ste 201
Los Angeles, CA 90012-2185
Phone (213) 217-5300

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191003002557 CA Practitioner - Nurse Practitioner 5395076418 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mission City Community Network, Inc. CurrentSince Aug 12, 2019 Accepting new patients
Mission City Community Network, Inc. CurrentSince Aug 12, 2019 Accepting new patients

Locations

8527 Sepulveda Blvd
North Hills, CA 91343
Phone (310) 926-4865

8363 Reseda Blvd
Ste 11
Northridge, CA 91324
Phone 8188953100602

15206 Parthenia St
Sepulveda, CA 91343

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.

NPI Registry JSON

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

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1033618509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W CESAR E CHAVEZ AVE STE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122185",
            "telephone_number": "213-217-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W CESAR E CHAVEZ AVE STE 201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900122185",
            "telephone_number": "213-217-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-09",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95008286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.