Jeong Ai Kim

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A105883 Issued in CA

Practice address

9310 Sierra Ave
Fontana, CA 92335-5711

Phone

(909) 427-3700

NPI assigned

Aug 12, 2009

Sex

Female

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: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

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.

• County of Riverside

  • Federally Qualified Health Center (FQHC)
  • Indio, CA
  • NPI 1023122967
  Medicare reassignment NPD
• County of Riverside

  • Community/Behavioral Health Agency
  • Riverside, CA
  • NPI 1063528891
  NPD
• County of Riverside

  • Clinical Medical Laboratory
  • Riverside, CA
  • NPI 1952496010
  NPD

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

{
    "created_epoch": "1250035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250035200000",
    "number": "1326270224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9310 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923355711",
            "telephone_number": "909-427-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9310 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923355711",
            "telephone_number": "909-427-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JEONG",
        "middle_name": "AI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-12",
        "last_updated": "2009-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A105883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugene Kim, M.D.
• Fabiana Sung Hyun Kim, MD
• Hannah Suh Kim, P.A.
• Hoon Kim, MD
• Jennifer K. Kim, MD
• Joel Chul Ju Kim, D.D.S.
• Jonathan Kim, D.D.S.
• Joseph Kim, MD
• Joseph Bo-Young Kim, M.D.
• Kyung-Il John Kim

• Psychiatry Physician in Fontana, CA
• Providers in Fontana, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; 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.