Active NPI
Hyuk Kim, D.O.
- Obstetrics & Gynecology Physician
- Pacoima, CA
National Provider Identifier
1205845583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 20A7982
- Practice address
- 13563 Van Nuys Blvd
Pacoima, CA 91331-3029 - Phone
- (818) 890-5300
- Fax
- (818) 890-0880
- NPI assigned
- Aug 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 20A7982 | CA | Primary |
Addresses
Primary practice location
13563 Van Nuys Blvd
Pacoima, CA 91331-3029
Mailing address
PO Box 8248
La Crescenta, CA 91224-0248
Phone (818) 890-5300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AX79820 | Medicaid | CA | |
| 9423834 | Other | CA | PIN |
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A7982 | CA | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207699200000",
"number": "1205845583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8248",
"city": "LA CRESCENTA",
"state": "CA",
"postal_code": "912240248",
"telephone_number": "818-890-5300",
"fax_number": "818-890-0880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13563 VAN NUYS BLVD",
"city": "PACOIMA",
"state": "CA",
"postal_code": "913313029",
"telephone_number": "818-890-5300",
"fax_number": "818-890-0880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "HYUK",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2008-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "CA",
"license": "20A7982",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00AX79820",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PIN",
"identifier": "9423834",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pacoima, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.