Individual provider Active NPI

Mindy Minjeong Kim, MD

  • Psychiatry Physician
  • San Francisco, CA
National Provider Identifier
1174218614
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A197696 Issued in CA
Practice address
675 18TH St
San Francisco, CA 94143-4200
Phone
(415) 476-7000
Fax
(415) 502-6361
NPI assigned
Apr 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A197696 CA Primary

Addresses

Primary practice location

675 18TH St
San Francisco, CA 94143-4200

Mailing address

675 18TH St
San Francisco, CA 94143-4200
Phone (416) 476-7000

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
I20250716001111 CA Practitioner - Psychiatry 8729448600 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Wayne State University School of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1202 Morena Blvd
Suite 100
San Diego, CA 92110-3841

1202 Morena Blvd
Suite 100
San Diego, CA 92110-3842

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A197696CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego Inc CurrentSince Aug 18, 2025 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Aug 18, 2025 Accepting new patients
Community Research Foundation Inc CurrentSince Jul 1, 2025 Accepting new patients
Family Health Centers of San Diego, Inc Current Accepting new patients

Locations

1202 Morena Blvd
Ste 300
San Diego, CA 92110
Phone (619) 276-8112

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

1809 National Ave
San Diego, CA 92113
Phone (619) 515-2500

1202 Morena Blvd
Ste 100
San Diego, CA 92110
Phone (619) 276-8112

545 Laurel St
San Diego, CA 92101
Phone (619) 233-4399

Interoperability endpoints

  • Direct secure messaging: mkim54845@syhealth.direct-ci.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": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1174218614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 18TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941434200",
            "telephone_number": "416-476-7000",
            "fax_number": "415-502-6361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 18TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941434200",
            "telephone_number": "415-476-7000",
            "fax_number": "415-502-6361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MINDY",
        "middle_name": "MINJEONG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A197696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.