Organization Active NPI

Stanley S. Kim, M.D.

  • Medical Specialty Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1073791687
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
G54395 Issued in CA
Legal business name
STANLEY S. KIM, M.D.
Practice address
3663 W 6TH St
Suite #200
Los Angeles, CA 90020-3049
Phone
(213) 385-8500
Fax
(213) 385-4896
NPI assigned
Feb 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Authorized official

Name
Dr. Stanley S. Kim, M.D.NPI 1003837840
Title
Owner
Phone
(213) 385-8500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X G54395 CA Primary

Addresses

Primary practice location

3663 W 6TH St
Suite #200
Los Angeles, CA 90020-3049

Mailing address

3663 W 6TH St
Suite #200
Los Angeles, CA 90020-3049
Phone (213) 385-8500

Other identifiers 3

IdentifierTypeStateIssuer
1050960002OtherCAMEDICARE DMEPOS SUPPLIER
00G543951MedicaidCA
00G543950MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202256000000",
    "number": "1073791687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3663 W 6TH ST",
            "address_2": "SUITE #200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203049",
            "telephone_number": "213-385-8500",
            "fax_number": "213-385-4896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3663 W 6TH ST",
            "address_2": "SUITE #200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203049",
            "telephone_number": "213-385-8500",
            "fax_number": "213-385-4896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANLEY S. KIM, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-02-06",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-385-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "G54395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMEPOS SUPPLIER",
            "identifier": "1050960002",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G543951",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G543950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.

Verify at the official NPI Registry.