Individual provider Active NPI

Whan Sil Kim, M.D.

  • Internal Medicine Physician
  • San Diego, CA
National Provider Identifier
1194891887
Registry record updated Jan 3, 2011
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Nov 20, 2013.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A35061 Issued in CA
Practice address
7825 Engineer Rd
Suite 101
San Diego, CA 92111-1924
Phone
(858) 277-7111
Fax
(858) 277-7667
NPI assigned
Nov 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A35061 CA Primary

Addresses

Primary practice location

7825 Engineer Rd
Suite 101
San Diego, CA 92111-1924

Mailing address

5042 Wilshire Blvd
Suite 620
Los Angeles, CA 90036-4305
Phone (213) 384-0077

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A35061CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Whan Sil Kim, M.D., Inc. Internal Medicine PastSince Feb 10, 2005 Accepting new patients
Pro Wellness Diagnostic Services Past Accepting new patients

Organizations & group practices 2

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": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294012800000",
    "number": "1194891887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5042 WILSHIRE BLVD",
            "address_2": "SUITE 620",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364305",
            "telephone_number": "213-384-0077",
            "fax_number": "213-384-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7825 ENGINEER RD",
            "address_2": "SUITE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111924",
            "telephone_number": "858-277-7111",
            "fax_number": "858-277-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "WHAN",
        "middle_name": "SIL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2011-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A35061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.