Active NPI
Kil Woo Kim, MD
- Internal Medicine Physician
- Selma, CA
National Provider Identifier
1205847993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A340310
- Practice address
- 1205 Evergreen St
Selma, CA 93662 - Phone
- (559) 896-2342
- Fax
- (559) 896-3421
- NPI assigned
- Aug 10, 2006
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A340310 | CA | Primary |
Addresses
Primary practice location
1205 Evergreen St
Selma, CA 93662
Mailing address
PO Box 1139
Selma, CA 93662
Phone (559) 896-2342
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090922000776 | CA | Practitioner - Internal Medicine | 1052467685 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A340310 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K.W. Kim, a Professional Corp | Internal Medicine | Current | Accepting new patients |
Locations
1205 Evergreen St
Selma, CA 93662
Phone (559) 896-2342
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Selma, CA
- NPI 1437482676
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205847993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1139",
"city": "SELMA",
"state": "CA",
"postal_code": "93662",
"telephone_number": "559-896-2342",
"fax_number": "559-896-3421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 EVERGREEN ST",
"city": "SELMA",
"state": "CA",
"postal_code": "93662",
"telephone_number": "559-896-2342",
"fax_number": "559-896-3421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "KIL",
"middle_name": "WOO",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A340310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Selma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.