Individual provider Active NPI

Gene Ho Kim, MD

  • Dermatopathology Physician
  • Los Angeles, CA
National Provider Identifier
1144208182
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
A104201 Issued in CA
Practice address
1450 San Pablo St Ste 2000
Los Angeles, CA 90033-4500
Phone
(323) 442-6200
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology Physician 207ND0900X A104201 CA Primary

Addresses

Primary practice location

1450 San Pablo St Ste 2000
Los Angeles, CA 90033-4500

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-6200

Other practice location 1

2011 Zonal Ave
Suite 209
Los Angeles, CA 90089-0110
Phone (323) 442-2582

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gene.kim@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

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
I20081204000496 CA Practitioner - DermatologyPractitioner - Pathology 0749296176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Pathology
Education
Indiana University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usc Care Medical Group IncGroup PAC ID 0446157747, 1,378 clinicians

Practice addresses (Care Compare)

1450 San Pablo St
Los Angeles, CA 90033-4500

1500 San Pablo St
Los Angeles, CA 90033-5313
Phone (323) 442-8444

1516 San Pablo St
Los Angeles, CA 90033-5313
Phone (800) 872-2273

1520 San Pablo St
Los Angeles, CA 90033-5310
Phone (800) 872-2273

1520 San Pablo St 1St Floor N
Los Angeles, CA 90033-5310
Phone (800) 872-2273

2011 Zonal Ave
Los Angeles, CA 90089-1016
Phone (323) 442-1156

Hospital & facility affiliations

  • Keck Hospital of Usc Hospital, Los Angeles, CA, CCN 050696
  • Usc Kenneth Norris Jr Cancer Hospital Hospital, Los Angeles, CA, CCN 050660
  • Huntington Hospital Hospital, Pasadena, CA, CCN 050438

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions49
Skin biopsy52

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc CurrentSince Jul 21, 2008 Accepting new patients
Usc Care Medical Group, Inc Dermatology CurrentSince Jul 21, 2008 Accepting new patients
University Pathology Associates, Inc. Past Accepting new patients
Orbuch, Brand Dermatology Associates LLP Dermatology PastSince May 13, 1997 Accepting new patients
University Dermatology, Inc. Dermatology PastSince Jan 1, 2007 Accepting new patients

Locations

2011 Zonal Ave
Los Angeles, CA 90089
Phone (626) 457-4136

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1450 San Pablo St
Ste 2000
Los Angeles, CA 90033
Phone (323) 221-3270

2011 Zonal Ave
Ste 209
Los Angeles, CA 90089

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1144208182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 SAN PABLO ST STE 2000",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900334500",
            "telephone_number": "323-442-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2011 Zonal Ave",
            "address_2": "Suite 209",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900890110",
            "country_code": "US",
            "telephone_number": "323-442-2582",
            "fax_number": "323-442-2588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "GENE",
        "middle_name": "HO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2023-11-27",
        "certification_date": "2020-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "A104201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gene.kim@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1450 San Pablo St Ste 2000",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900334500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.