Alice R Kim, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A9216 Issued in CA

Practice address

441 N Lakeview Ave
Anaheim, CA 92807-3028

Phone

(714) 279-5990

NPI assigned

Jun 28, 2007

Last updated

Nov 1, 2021By the provider in NPPES

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

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Hawthorne, CA
  • NPI 1164914115
  NPD
• Foundation Radiology Group PC

  • Diagnostic Radiology Physician
  • Wexford, PA
  • NPI 1740482686
  NPD (past)

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1366649832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2664 CAMINO DEL SOL",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "92833",
            "telephone_number": "714-441-0944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 N LAKEVIEW AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928073028",
            "telephone_number": "714-279-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ALICE",
        "middle_name": "R",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A9216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "25825 Vermont Ave",
            "city": "Harbor City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907103518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Suheir Kilani, PA-C
• Sherilyn Kile, ED.S., PPS, - 230115
• Shea Thomas Kilty-Lomibao
• Kim & Lee a Dental Corporation
• Kim Chiropractic & Acupuncture Inc.
• Allen Taesoo Kim, DDS
• Alvin C Kim, PHARM.D.
• Alysha Kim
• Ashley Kim
• Ashley Suyon Kim, RDN

• Family Medicine Physician in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.