Active NPI
Deborah Kim
- Medical Physician Assistant
- Glendale, CA
National Provider Identifier
1316627565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 62014
- Practice address
- 500 E Colorado St
Glendale, CA 91205-1607 - Phone
- (818) 246-4800
- NPI assigned
- Jul 21, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 62014 | CA | Primary |
Addresses
Primary practice location
500 E Colorado St
Glendale, CA 91205-1607
Mailing address
500 E Colorado St
Glendale, CA 91205-1607
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Interoperability endpoints
- deborah.kim@3856.securemail.prognocis.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689897600000",
"number": "1316627565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 E COLORADO ST",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912051607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 E COLORADO ST",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912051607",
"telephone_number": "818-246-4800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "DEBORAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-21",
"last_updated": "2023-07-21",
"certification_date": "2023-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "62014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.