Individual provider Active NPI

Dalim Ki, DO

  • Family Medicine Physician
  • San Francisco, CA
National Provider Identifier
1114396405
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP60965939 Issued in WA
Practice address
1 California St Ste 2300
San Francisco, CA 94111-5424
Phone
(800) 997-6196
Fax
(415) 504-1367
NPI assigned
Sep 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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 OP60965939 WA Primary

Addresses

Primary practice location

1 California St Ste 2300
San Francisco, CA 94111-5424

Mailing address

1 California St Ste 2300
San Francisco, CA 94111-5424
Phone (800) 997-6196

Other identifiers 1

IdentifierTypeStateIssuer
2064737MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20191024002956 WA Practitioner - Family PracticePractitioner - Other (Physician) 6800183740 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP60965939WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics LLC CurrentSince Aug 9, 2021 Accepting new patients
Doctor on Demand Professionals P C Family Medicine CurrentSince Jul 5, 2023 Accepting new patients
Overlake Medical Clinics, LLC CurrentSince Aug 9, 2021 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926

10300 Greenbriar Pl
Oklahoma City, OK 73159
Phone (405) 962-1800

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

300 Deschutes Way SW
Ste 208
Tumwater, WA 98501
Phone (617) 249-6854

Interoperability endpoints

  • Direct secure messaging: dalim.ki.1@30520.direct.athenahealth.com

Organizations & group practices 4

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": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1114396405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CALIFORNIA ST STE 2300",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941115424",
            "telephone_number": "800-997-6196",
            "fax_number": "415-504-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CALIFORNIA ST STE 2300",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941115424",
            "telephone_number": "800-997-6196",
            "fax_number": "415-504-1367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KI",
        "first_name": "DALIM",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP60965939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2064737",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.