JCK Medical Corp

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

JCK MEDICAL CORP

Practice address

11500 W Olympic Blvd Ste 480
Los Angeles, CA 90064-1678

Phone

(310) 477-4727

Fax

(310) 477-2001

NPI assigned

Mar 21, 2021

Last updated

Mar 21, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christine Kim, MDNPI 1306827324

Title

Vice- President

Phone

(917) 301-1118

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christine Choi Kim, M.D.

  • Dermatology Physician
  • Los Angeles, CA
  • NPI 1306827324
  NPD Authorized official

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

{
    "created_epoch": "1616284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616284800000",
    "number": "1396321345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 W OLYMPIC BLVD STE 480",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641678",
            "telephone_number": "310-477-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 W OLYMPIC BLVD STE 480",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900641678",
            "telephone_number": "310-477-4727",
            "fax_number": "310-477-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JCK MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-21",
        "last_updated": "2021-03-21",
        "certification_date": "2021-03-21",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "VICE- PRESIDENT",
        "authorized_official_telephone_number": "917-301-1118",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Dermatology Physician in California

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

Verify at the official NPI Registry.