Individual provider Active NPI

Kil Woo Kim, MD

  • Internal Medicine Physician
  • Selma, CA
National Provider Identifier
1205847993
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A340310 Issued in CA
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

Updated by the provider on Jul 8, 2007

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090922000776 CA Practitioner - Internal MedicinePractitioner - General Practice 1052467685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A340310CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
K.W. Kim, a Professional Corp Internal Medicine CurrentSince Jun 21, 2009 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.

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

Verify at the official NPI Registry.