Active NPI
Jayden Kim
- Physical Therapist
- Los Angeles, CA
National Provider Identifier
1386315380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 5901 W Olympic Blvd Ste 407
Los Angeles, CA 90036-4669 - Phone
- (323) 917-5194
- NPI assigned
- Sep 21, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
5901 W Olympic Blvd Ste 407
Los Angeles, CA 90036-4669
Mailing address
2646 Kenwood Ave Apt 4
Los Angeles, CA 90007-2107
Phone (310) 508-2075
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| All Star Physical Therapy | Physical Therapist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapist
- Murrieta, CA
- NPI 1750559431
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632182400000",
"number": "1386315380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2646 KENWOOD AVE APT 4",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900072107",
"telephone_number": "310-508-2075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 W OLYMPIC BLVD STE 407",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900364669",
"telephone_number": "323-917-5194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JAYDEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-09-21",
"last_updated": "2021-09-21",
"certification_date": "2021-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.