Michael J Kim DPM PC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

Legal business name

MICHAEL J KIM DPM PC

Doing business as

Grace Foot and Ankle Center

Practice address

9353 Fairway View PL Ste 100
Rancho Cucamonga, CA 91730-0961

Phone

(909) 858-2772

Fax

(909) 300-6324

NPI assigned

Aug 15, 2022

Last updated

Dec 2, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lucia Kim

Title

Office Manager

Phone

(269) 317-4098

Specialties & licenses 1

Addresses

Other names 1

• GRACE FOOT AND ANKLE CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Jae Bum Kim, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Rancho Cucamonga, CA
  • NPI 1073951190
  Medicare reassignment NPD

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1316665524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23141 VERDUGO DR STE 201",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926531341",
            "telephone_number": "949-215-5055",
            "fax_number": "949-326-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9353 FAIRWAY VIEW PL STE 100",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300961",
            "telephone_number": "909-858-2772",
            "fax_number": "909-300-6324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J KIM DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "LUCIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "269-317-4098"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRACE FOOT AND ANKLE CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GRACE FOOT AND ANKLE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mi Paz Counseling Kenny and Leslie Gallegos LCSW PC
• Mia Velarde
• Michael Andrews (Rancho Spine and Sport)
• Michael Azer, D.M.D., Inc.
• Michael B Phillips (Ontario Prosthetic Systems)
• Kylee Mariko Michalski, PT, DPT
• Mirella Hernandez Michel
• Sarah Michlin, RBT
• Rachel M Mickel, LCSW
• Erika Mier

• Podiatric Clinic/Center in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Podiatric Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.