Tae Hyun Kim DPM Inc

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E4262 Issued in CA

Legal business name

TAE HYUN KIM DPM INC

Practice address

13701 Burbank Blvd
Van Nuys, CA 91401-5040

Phone

(818) 997-1216

Fax

(818) 997-4458

NPI assigned

Aug 17, 2009

Organization subpart

No

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

Authorized official

Name

Tae H Kim, D.P.M.NPI 1083651038

Title

President

Phone

(818) 997-1216

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tae Hyun Kim, D P M INC

  • Podiatrist
  • Van Nuys, CA
  • NPI 1083651038
  Medicare reassignment Authorized official
• Michael Blake Runyon, DPM

  • Foot Surgery Podiatrist
  • Van Nuys, CA
  • NPI 1225006950
  NPD (past)

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257120000000",
    "number": "1295967719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13701 BURBANK BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914015040",
            "telephone_number": "818-997-1216",
            "fax_number": "818-997-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13701 BURBANK BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914015040",
            "telephone_number": "818-997-1216",
            "fax_number": "818-997-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAE HYUN KIM DPM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-17",
        "last_updated": "2009-11-02",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "TAE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-997-1216",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "E4262",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melisa M. Tablada, CADC II (CA)
• Alicia Taboada
• Vanessa E. Tabungar, NP
• George Tachejian, MSN, PMHNP-BC
• Amira Tadrous Khalil, DMD
• Amy Altman Taff, LCSW
• Glareh Tafreshi
• Tag Hospice Inc
• Javan Lee Taherkhani
• Tai Kwong Lee,MD,PHD, Inc

• Foot & Ankle Surgery Podiatrist in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; 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.