Individual provider Active NPI

Dean Kim, M.D.

  • Emergency Medicine Physician
  • Carmichael, CA
National Provider Identifier
1124069463
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G34331 Issued in CA
Practice address
4156 Manzanita Ave
Suite 100
Carmichael, CA 95608-1726
Phone
(916) 483-5400
Fax
(916) 483-1937
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G34331 CA Primary

Addresses

Primary practice location

4156 Manzanita Ave
Suite 100
Carmichael, CA 95608-1726

Mailing address

4156 Manzanita Ave
Suite 100
Carmichael, CA 95608-1726
Phone (916) 483-5400

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
I20100429000370 CA Practitioner - Emergency MedicinePractitioner - Other (Physician) 8527195213

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G34331CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Med-7 Urgent Care Center Medical Group CurrentSince Dec 12, 2000 Accepting new patients
Med-7 Urgent Care Center Medical Group CurrentSince Dec 12, 2000 Accepting new patients

Locations

4156 Manzanita Ave
Ste 100
Carmichael, CA 95608
Phone (916) 483-5400

701 Sunrise Ave
Roseville, CA 95661
Phone (916) 483-5400

Organizations & group practices 2

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124069463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4156 MANZANITA AVE",
            "address_2": "SUITE 100",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956081726",
            "telephone_number": "916-483-5400",
            "fax_number": "916-483-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4156 MANZANITA AVE",
            "address_2": "SUITE 100",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956081726",
            "telephone_number": "916-483-5400",
            "fax_number": "916-483-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G34331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

Verify at the official NPI Registry.