Individual provider Active NPI

Yohanan Kim

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Riverside, CA
National Provider Identifier
1265965339
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
A157124 Issued in CA
Practice address
6405 Day St
Riverside, CA 92507-0901
Phone
(951) 697-5570
Fax
(951) 697-5596
NPI assigned
Apr 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A157124 CA
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X A157124 CA Primary

Addresses

Primary practice location

6405 Day St
Riverside, CA 92507-0901

Mailing address

6405 Day St
Riverside, CA 92507-0901
Phone (951) 697-5570

Other practice location 1

11234 Anderson St
Loma Linda University Health, Otolaryngology
Loma Linda, CA 92350-1716
Phone (909) 558-8558

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

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
I20220606002200 CA Practitioner - Otolaryngology 5799163614 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Loma Linda University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Medical Clinic IncGroup PAC ID 2961492327, 173 clinicians

Practice addresses (Care Compare)

6405 Day St
Riverside, CA 92507-0901
Phone (951) 697-5556

Hospital & facility affiliations

  • Riverside Community Hospital Hospital, Riverside, CA, CCN 050022

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A157124CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Medical Clinic, Inc CurrentSince Oct 16, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 1, 2022 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 28, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Dec 28, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 1, 2022 Accepting new patients
Riverside Medical Clinic, Inc Otolaryngology CurrentSince Oct 16, 2023 Accepting new patients
Riverside Medical Clinic, Inc Otolaryngology Current Accepting new patients
Physicians' Hospital of Murrieta, LLC Past Accepting new patients
RMC Surgery Center, LLC Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

25845 Barton Rd
Ste F
Loma Linda, CA 92354
Phone (909) 558-2828

11370 Anderson St
Ste 2100
Loma Linda, CA 92354
Phone (909) 558-2824

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

11234 Anderson St
Ofc
Loma Linda, CA 92350
Phone (909) 558-4074

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Ste 2021
Moreno Valley, CA 92555
Phone (951) 486-5700

28078 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

6405 Day St
Ste Reet
Riverside, CA 92507

7160 Brockton Ave
Fl 2
Riverside, CA 92506
Phone (951) 782-3837

6405 Day St
Riverside, CA 92507
Phone (909) 683-6370

7160 Brockton Ave
Riverside, CA 92506
Phone (951) 782-3714

44274 George Cushman Ct
Ste 208
Temecula, CA 92592
Phone (951) 501-4200

21634 Retreat Pkwy
Temescal Valley, CA 92883
Phone (951) 782-5157

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1265965339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 DAY ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070901",
            "telephone_number": "951-697-5570",
            "fax_number": "951-697-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 DAY ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070901",
            "telephone_number": "951-697-5570",
            "fax_number": "951-697-5596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_2": "Loma Linda University Health, Otolaryngology",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923501716",
            "country_code": "US",
            "telephone_number": "909-558-8558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "YOHANAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-06",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A157124",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "CA",
            "license": "A157124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.