Active NPI
Ha Neul Kim, NURSE PRACTITIONER
- Family Medicine Physician
- Riverside, CA
National Provider Identifier
1154265874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 95036905
- Practice address
- 9172 Indiana Ave
Riverside, CA 92503-0114 - Phone
- (707) 328-8401
- NPI assigned
- Apr 14, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 95036905 | CA | Primary |
Addresses
Primary practice location
9172 Indiana Ave
Riverside, CA 92503-0114
Mailing address
9172 Indiana Ave
Riverside, CA 92503-0114
Phone (707) 328-8401
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95036905 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776124800000",
"number": "1154265874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9172 INDIANA AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925030114",
"telephone_number": "707-328-8401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9172 INDIANA AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925030114",
"telephone_number": "707-328-8401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "HA NEUL",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-04-14",
"last_updated": "2026-04-14",
"certification_date": "2026-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "95036905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.