D S Kim MD Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A24477 Issued in CA

Legal business name

D S KIM MD INC

Practice address

12601 Garden Grove Blvd
Garden Grove, CA 92843-1908

Phone

(714) 636-0343

Fax

(714) 636-0391

NPI assigned

May 12, 2006

Organization subpart

No

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

Authorized official

Name

Daniel S Kim, MD

Title

President

Phone

(714) 636-0343

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Daniel S Kim MD Former legal business name

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428883200000",
    "number": "1083665210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 788",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925460788",
            "telephone_number": "714-636-0343",
            "fax_number": "714-636-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12601 GARDEN GROVE BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431908",
            "telephone_number": "714-636-0343",
            "fax_number": "714-636-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D S KIM MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2015-04-13",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-636-0343",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A24477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A244770",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "AX331A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCARE PTAN",
            "identifier": "AX331B",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Daniel S Kim MD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Anesthesiology Physician in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; 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.