Adeline Kim, MD

Primary specialty

Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X

License

A168156 Issued in CA

Practice address

11234 Anderson St # MC-2534
Loma Linda, CA 92354-2804

Phone

(909) 558-8054

Fax

(909) 558-0187

NPI assigned

Jul 10, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: akim315388@direct.llu.edu

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.

• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917
  Medicare reassignment NPD
• Faculty Physicians and Surgeons of Llusm

  • Pediatrics Physician
  • Loma Linda, CA
  • NPI 1477503407
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Family Medicine Physician
  • Moreno Valley, CA
  • NPI 1558788331
  NPD

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1174907927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST # MC-2534",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-8054",
            "fax_number": "909-558-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST # MC-2534",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-8054",
            "fax_number": "909-558-0187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Carson St",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905022004",
            "country_code": "US",
            "telephone_number": "310-222-2409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "ADELINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-10",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "CA",
            "license": "A168156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William H Kiernan, OD
• Robert D Kiger, DDS
• Shirley Cho Kilian, PHD
• J. David Killeen, M.D.
• Abraham Kevin Kim, MD
• Adrienne Kim
• Annie Jiyoung Kim, PHARM.D.
• Annie Lee Kim, MS, RD
• Ashley Ann Kim
• Bobae Lee Kim, MD

• Pediatric Anesthesiology Physician in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Pediatric Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.