NPIMap

Individual provider Active NPI

Hong Sik Kim, M.D.

  • Nephrology Physician
  • Garden Grove, CA
National Provider Identifier
1396727764
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A45579 Issued in CA
Practice address
12665 Garden Grove Blvd
Suite 503
Garden Grove, CA 92843-1901
Phone
(714) 530-3740
Fax
(714) 530-0582
NPI assigned
Nov 18, 2005
Last updated
Nov 7, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X A45579 CA Primary

Addresses

Primary practice location

12665 Garden Grove Blvd
Suite 503
Garden Grove, CA 92843-1901

Mailing address

12665 Garden Grove Blvd
Suite 503
Garden Grove, CA 92843-1901
Phone (714) 530-3740

Other identifiers 2

IdentifierTypeStateIssuer
A455792OtherCAPRIVATE INSURANCES
00A455792MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100624000289 CA Practitioner - Internal MedicinePractitioner - Geriatric MedicinePractitioner - Nephrology 4082745781 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12665 Garden Grove Blvd
Suite 503
Garden Grove, CA 92843-1919
Phone (714) 534-6516

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A45579CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hong S. Kim, M.D., Inc Nephrology CurrentSince Jul 1, 1998 Accepting new patients
Chaewon Song, MD, Inc CurrentSince May 1, 2025 Accepting new patients
Hong S. Kim MD, Inc Current Accepting new patients
Hong S. Kim, MD, Inc Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Providence Medical Foundation Past Accepting new patients
St. Joseph Hospital Past Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients

Locations

12665 Garden Grove Blvd
Garden Grove, CA 92843
Phone (714) 537-5302

12665 Garden Grove Blvd
Ste 503
Garden Grove, CA 92843
Phone (714) 530-3740

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 11

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 3

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": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1396727764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD",
            "address_2": "SUITE 503",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431901",
            "telephone_number": "714-530-3740",
            "fax_number": "714-530-0582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12665 GARDEN GROVE BLVD",
            "address_2": "SUITE 503",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928431901",
            "telephone_number": "714-530-3740",
            "fax_number": "714-530-0582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HONG",
        "middle_name": "SIK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A45579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE INSURANCES",
            "identifier": "A455792",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A455792",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Grove, CA

Sources for this page

Verify at the official NPI Registry.