Chin Goo Kim, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A34967 Issued in CA

Practice address

3400 W Ball Rd Ste 208
Anaheim, CA 92804-3735

Phone

(714) 761-0759

Fax

(714) 761-3758

NPI assigned

Dec 31, 2007

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Chin G. Kim, M.D., Inc.

  • Specialist
  • Anaheim, CA
  • NPI 1689635906
  Medicare reassignment NPD Authorized official
• Anaheim Global Medical Center, Inc

  • General Acute Care Hospital
  • Anaheim, CA
  • NPI 1790778488
  NPD (past)
• Anaheim Memorial Medical Center

  • General Acute Care Hospital
  • Anaheim, CA
  • NPI 1295782381
  NPD (past)
• Buena Park Medical Group

  • Family Medicine Physician
  • Buena Park, CA
  • NPI 1477625671
  NPD (past)

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291680000000",
    "number": "1295910958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 W BALL RD",
            "address_2": "SUITE 208",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043738",
            "telephone_number": "714-761-0759",
            "fax_number": "714-761-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W BALL RD STE 208",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043735",
            "telephone_number": "714-761-0759",
            "fax_number": "714-761-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHIN",
        "middle_name": "GOO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-31",
        "last_updated": "2010-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A34967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Paul Kim, MD
• Byunggon Kim
• Byungwook Kim
• Casey D Kim, DC., LAC.
• Catherine Kim, O.D.
• Chin SE Kim, M.D.
• Chloe Kim, NP
• Chong Sang Kim, MD
• Chongweon Kim
• Christina Kim, DMD

• Specialist in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2010; 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.

Verify at the official NPI Registry.