Individual provider Active NPI

Myeong Cheol Kim, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Los Angeles, CA
National Provider Identifier
1386748325
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
C50796 Issued in CA
Practice address
2140 W Olympic Blvd Ste 210
Los Angeles, CA 90006-2277
Phone
(213) 381-5454
Fax
(213) 381-5300
NPI assigned
Sep 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X C50796 CA Primary

Addresses

Primary practice location

2140 W Olympic Blvd Ste 210
Los Angeles, CA 90006-2277

Mailing address

2140 W Olympic Blvd Ste 210
Los Angeles, CA 90006-2277
Phone (213) 381-5454

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
I20040517000771 CA Practitioner - Physical Medicine and Rehabilitation 4385634724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2140 W Olympic Blvd
Suite 210
Los Angeles, CA 90006-2277
Phone (213) 381-5454

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Myeong Cheol Kim, M.D., Inc. Physical Medicine & Rehabilitation CurrentSince Jan 30, 2003 Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients
Cha Hollywood Medical Center, LP Past Accepting new patients

Locations

8111 Commonwealth Ave
Buena Park, CA 90621
Phone (213) 381-5454

2140 W Olympic Blvd
Ste 210
Los Angeles, CA 90006
Phone (213) 381-5454

2727 W Olympic Blvd
Ste 210
Los Angeles, CA 90006
Phone (213) 674-7517

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386748325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 W OLYMPIC BLVD STE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062277",
            "telephone_number": "213-381-5454",
            "fax_number": "213-381-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 W OLYMPIC BLVD STE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062277",
            "telephone_number": "213-381-5454",
            "fax_number": "213-381-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MYEONG",
        "middle_name": "CHEOL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "C50796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.