Individual provider Active NPI

Seo Ho Kim

  • Physician Assistant
  • San Francisco, CA
National Provider Identifier
1104490093
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10451 Issued in GA
Practice address
1101 Van Ness Ave
San Francisco, CA 94109-6919
Phone
(415) 600-6000
NPI assigned
May 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10451 GA Primary

Addresses

Primary practice location

1101 Van Ness Ave
San Francisco, CA 94109-6919

Mailing address

1101 Van Ness Ave
San Francisco, CA 94109-6919
Phone (415) 600-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220527000444 GA Practitioner - Physician Assistant 1052799368
I20250602002173 CA Practitioner - Physician Assistant 1052799368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.01 of 100Reported as group
Quality
90
Improvement activities
40
Cost
68.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10451GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
California Advanced Imaging Medical Associates Inc CurrentSince Jul 1, 2025 Accepting new patients

Locations

1260 S Eliseo Dr
Ste 101
Greenbrae, CA 94904
Phone (415) 461-9033

2333 Buchanan St
San Francisco, CA 94115
Phone (415) 563-4321

1101 Van Ness Ave
San Francisco, CA 94109
Phone (415) 485-8824

100 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 696-4140

347 Andrieux St
Sonoma, CA 95476
Phone (707) 935-5000

Interoperability endpoints

  • Direct secure messaging: skim740638@hisp.ehr.sutterhealth.org

Organizations & group practices 1

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": "1621209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1104490093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 VAN NESS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941096919",
            "telephone_number": "415-600-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 VAN NESS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941096919",
            "telephone_number": "415-600-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SEO HO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-17",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.