Active NPI
Ok Suk Kim, MD
- Obstetrics & Gynecology Physician
- Riverside, CA
National Provider Identifier
1376542852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- A37206
- Practice address
- 3975 Jackson St
Ste 110
Riverside, CA 92503-3901 - Phone
- (951) 351-1071
- Fax
- (951) 351-1207
- NPI assigned
- Jul 18, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | A37206 | CA | Primary |
Addresses
Primary practice location
3975 Jackson St
Ste 110
Riverside, CA 92503-3901
Mailing address
3975 Jackson St
Ste 110
Riverside, CA 92503-3901
Phone (951) 351-1071
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A37206 | CA | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376542852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3975 JACKSON ST",
"address_2": "STE 110",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925033901",
"telephone_number": "951-351-1071",
"fax_number": "951-351-1207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3975 JACKSON ST",
"address_2": "STE 110",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925033901",
"telephone_number": "951-351-1071",
"fax_number": "951-351-1207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "OK",
"middle_name": "SUK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "CA",
"license": "A37206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.