Benneth Bundit Kim, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

302944 Issued in CA

Practice address

4200 Chino Hills Pkwy Ste 825
Chino Hills, CA 91709-5832

Phone

(310) 808-7612

NPI assigned

Oct 11, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairbanks and Power Physical Therapy CorpGroup PAC ID 6406843481, 53 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fairbanks & Power Physical Therapy Corp.

  • Physical Therapist
  • Irvine, CA
  • NPI 1912953936

  Multi-Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737158400000",
    "number": "1144945189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20516 EARL ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905033007",
            "telephone_number": "310-808-7612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 CHINO HILLS PKWY STE 825",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917095832",
            "telephone_number": "310-808-7612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "BENNETH",
        "middle_name": "BUNDIT",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-11",
        "last_updated": "2025-01-18",
        "certification_date": "2025-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302944",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "benkimdpt@outlook.com",
            "affiliation": "N",
            "address_1": "20516 Earl St",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905033007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Duaa Kheirieh, PSYD
• Neha Khushalani
• Doris A.K. Kilzi, PHARM D
• Kim and Gandhi Kim Dental Corporation
• Alex Kim, MSN, RN, FNP-C
• Jeffrey Kim, DDS
• Jenny Kim
• Jin Young Kim, DDS, MS
• Karis Kim
• Lauren J Kim, PHARM. D.

• Physical Therapist in Chino Hills, CA
• Providers in Chino Hills, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.