Individual provider Active NPI

Kim Kia Yu, MD

  • Family Medicine Physician
  • Irvine, CA
National Provider Identifier
1063483667
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301070014 Issued in MI
Practice address
19742 Macarthur Blvd Ste 250
Irvine, CA 92612-2488
Phone
(714) 503-6550
Fax
(714) 309-4075
NPI assigned
Jan 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301070014 MI Primary

Addresses

Primary practice location

19742 Macarthur Blvd Ste 250
Irvine, CA 92612-2488

Mailing address

451 W Lincoln Ave Ste 100
Anaheim, CA 92805-2912
Phone (714) 503-6550

Other practice location 1

451 W Lincoln Ave Ste 100
Anaheim, CA 92805-2912
Phone (714) 503-6550

Other identifiers 5

IdentifierTypeStateIssuer
080H232630OtherMIBCN GROUP
4397890-10MedicaidMI
080H232630OtherMIBCBS GROUP
0808290401OtherMIBCBS BCN
1063483667MedicaidMI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241108002890 CA Practitioner - Family Practice 5193870467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
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)

23781 Maquina
Mission Viejo, CA 92691-2716
Phone (888) 988-2800

3401 S Harbor Blvd
Santa Ana, CA 92704-7933
Phone (888) 988-2800

5475 E la Palma Ave
Anaheim, CA 92807-2075
Phone (714) 279-6088

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Oct 27, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 27, 2025 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

5475 E La Palma Ave
Anaheim, CA 92807
Phone (714) 279-6088

Organizations & group practices 3

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1063483667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 W LINCOLN AVE STE 100",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928052912",
            "telephone_number": "714-503-6550",
            "fax_number": "714-409-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19742 MACARTHUR BLVD STE 250",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926122488",
            "telephone_number": "714-503-6550",
            "fax_number": "714-309-4075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "451 W Lincoln Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928052912",
            "country_code": "US",
            "telephone_number": "714-503-6550",
            "fax_number": "714-409-3075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YU",
        "first_name": "KIM",
        "middle_name": "KIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301070014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN GROUP",
            "identifier": "080H232630",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4397890-10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "080H232630",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BCN",
            "identifier": "0808290401",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063483667",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.