NPIMap

Organization Active NPI

Hong S. Kim, M.D., Inc

  • Nephrology Physician
  • Garden Grove, CA
National Provider Identifier
1245421353
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A45579 Issued in CA
Legal business name
HONG S. KIM, M.D., INC
Practice address
12665 Garden Grove Blvd Ste 503
Garden Grove, CA 92843-1919
Phone
(714) 530-3740
Fax
(714) 530-0582
NPI assigned
Aug 5, 2007
Last updated
Nov 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Authorized official

Name
Hong S Kim, MDNPI 1396727764
Title
Owner
Phone
(714) 530-3740

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X A45579 CA Primary

Addresses

Primary practice location

12665 Garden Grove Blvd Ste 503
Garden Grove, CA 92843-1919

Mailing address

12665 Garden Grove Blvd Ste 503
Garden Grove, CA 92843-1919
Phone (714) 530-3740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050715001088 CA Part B Supplier - Clinic/Group Practice 0244266682 Receives reassigned benefits from 2 practitioners
Practice locations: Garden Grove, CA

National Provider Directory

National Provider Directory
Tax ID family
Hong S Kim MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1245421353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 503",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431919",
            "telephone_number": "714-530-3740",
            "fax_number": "714-530-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD STE 503",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431919",
            "telephone_number": "714-530-3740",
            "fax_number": "714-530-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HONG S. KIM, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2013-11-07",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "HONG",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-530-3740",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A45579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.