Kenneth K Kim, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G71557 Issued in CA

Practice address

520 S Virgil Ave
Suite 106
Los Angeles, CA 90020-1416

Phone

(213) 234-5575

Fax

(213) 427-9850

NPI assigned

Jun 9, 2006

Last updated

Nov 18, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

Loma Linda University School of Medicine, 1989

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacific Senior Medical Group

  • Health Maintenance Organization
  • Los Angeles, CA
  • NPI 1831049618
  NPD Authorized official
• Advanced Premier Physicians Aco

  • Exclusive Provider Organization
  • Cerritos, CA
  • NPI 1376958942
  Authorized official Same address or phone
• Kenneth K Kim, a Medical Corporation

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1295004034
  NPD (past) Authorized official
• Foothill Plaza Medical Group

  • Family Medicine Physician
  • La Canada, CA
  • NPI 1194739433
  NPD (past)
• Sutter Bay Hospitals

  dba Alta Bates Summit Medical Center - Summit Campus

  • Rehabilitation Hospital Unit
  • Oakland, CA
  • NPI 1194171371
  NPD (past)
• Memorial Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1255523643
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1295776474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 741519",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90004",
            "telephone_number": "213-234-5575",
            "fax_number": "213-427-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S VIRGIL AVE",
            "address_2": "SUITE 106",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201416",
            "telephone_number": "213-234-5575",
            "fax_number": "213-427-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KENNETH",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G71557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Kim, M.D.
• Karen Hyun Kim, PHARMD
• Katherine Y. Kim
• Kathryn Kim
• Kay Kim, LMFT, PSYD
• Kenneth Taeyoung Kim, MD
• Kenneth Taik Kim, PT, DPT
• Kevin C Kim, M.D
• Kevin Young Kim
• Ki H Kim, M.S., L.AC.

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.