Individual provider Active NPI

Preston Kim

  • Hospitalist Physician
  • Irvine, CA
National Provider Identifier
1043912017
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A200842 Issued in CA
Practice address
16200 Sand Canyon Ave
Irvine, CA 92618-3714
Phone
(877) 742-4624
NPI assigned
Mar 21, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X A200842 CA Primary

Addresses

Primary practice location

16200 Sand Canyon Ave
Irvine, CA 92618-3714

Mailing address

11234 Anderson St Ste C
Loma Linda, CA 92354-2804
Phone (909) 558-4074

Other practice location 1

16250 Sand Canyon Ave
Irvine, CA 92618-3714
Phone (877) 742-4624

Other practice location 2

11234 Anderson St Ste C
Loma Linda, CA 92354-2804
Phone (909) 558-4074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1043912017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST STE C",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-4074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16200 SAND CANYON AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183714",
            "telephone_number": "877-742-4624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16250 Sand Canyon Ave",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926183714",
            "country_code": "US",
            "telephone_number": "877-742-4624",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11234 Anderson St Ste C",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-4074",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "PRESTON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-21",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A200842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.