Active NPI
Paul Kim
- Nursing Home Administrator
- Irvine, CA
National Provider Identifier
1205567963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Home Administrator
- License
- 7600
- Practice address
- 20 Maxwell
Irvine, CA 92618-4641 - Phone
- (661) 670-3031
- NPI assigned
- Jun 22, 2022
- Last updated
- Jun 22, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Nursing Home Administrator | 376G00000X | 7600 | CA | Primary |
Addresses
Primary practice location
20 Maxwell
Irvine, CA 92618-4641
Mailing address
20 Maxwell
Irvine, CA 92618-4641
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Irvine | ||
| CONNECT URL | Irvine |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vita Star Home Healthcare Inc | Current | Accepting new patients | |
| Alta Home Health Care Services, Inc. | Current | Accepting new patients |
Locations
20 Maxwell
Irvine, CA 92618
Phone (661) 670-3031
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Home Health Agency
- Garden Grove, CA
- NPI 1801565908
-
- Home Health Agency
- Stanton, CA
- NPI 1154266344
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655856000000",
"number": "1205567963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 MAXWELL",
"city": "IRVINE",
"state": "CA",
"postal_code": "926184641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 MAXWELL",
"city": "IRVINE",
"state": "CA",
"postal_code": "926184641",
"telephone_number": "661-670-3031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-22",
"last_updated": "2022-06-22",
"certification_date": "2022-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "376G00000X",
"taxonomy_group": "",
"desc": "Nursing Home Administrator",
"state": "CA",
"license": "7600",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Irvine",
"affiliation": "N",
"address_1": "20 Maxwell",
"city": "Irvine",
"state": "CA",
"country_code": "US",
"postal_code": "926184641",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Irvine",
"affiliation": "N",
"address_1": "20 Maxwell",
"city": "Irvine",
"state": "CA",
"country_code": "US",
"postal_code": "926184641",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Irvine, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.