James DS Kim, MD, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

A20931 Issued in CA

Legal business name

JAMES DS KIM, MD, INC.

Practice address

700 S Ham LN
Lodi, CA 95242-3536

Phone

(209) 368-5196

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. James DS Kim, M.D.

Title

Ceo

Phone

(209) 368-5196

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336260868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 S HAM LN",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423536",
            "telephone_number": "209-368-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S HAM LN",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423536",
            "telephone_number": "209-368-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES DS KIM, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "DS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-368-5196",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A20931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "563729",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CL",
            "identifier": "05DO685922",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.