Individual provider Active NPI

Jongjin Kim, M.D.

  • Internal Medicine Physician
  • La Palma, CA
National Provider Identifier
1356605836
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A133928 Issued in CA
Practice address
5471 La Palma Ave
La Palma, CA 90623-1745
Phone
(714) 752-6088
Fax
(657) 577-9135
NPI assigned
Jun 28, 2012
Last updated
Apr 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A133928 CA Primary

Addresses

Primary practice location

5471 La Palma Ave
La Palma, CA 90623-1745

Mailing address

145 Versailles Cir Apt D
Towson, MD 21204-6933
Phone (443) 862-6573

Other identifiers 2

IdentifierTypeStateIssuer
N/AOtherMDMEDICARE
N/AMedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220418001217 CA Practitioner - Internal Medicine 6305097015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5471 La Palma Ave
Suite 200
La Palma, CA 90623-4702
Phone (714) 752-6088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A133928CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jongjin Kim MD Inc Internal Medicine CurrentSince Jan 20, 2025 Accepting new patients

Locations

5471 La Palma Ave
Ste 200
La Palma, CA 90623
Phone (714) 495-4392

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jongjin.kim@377404868722692.direct.elationemr.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1356605836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 VERSAILLES CIR APT D",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212046933",
            "telephone_number": "443-862-6573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5471 LA PALMA AVE",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231745",
            "telephone_number": "714-752-6088",
            "fax_number": "657-577-9135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JONGJIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-28",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A133928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "N/A",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N/A",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Palma, CA

Sources for this page

Verify at the official NPI Registry.