NPIMap

Individual provider Active NPI

Sean Youngjin Kim, M.D.

  • Surgery Physician
  • Monterey Park, CA
National Provider Identifier
1457630055
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A123580 Issued in CA
Practice address
600 N Garfield Ave Ste 210
Monterey Park, CA 91754-1170
Phone
(626) 573-8282
Fax
(626) 573-8338
NPI assigned
Aug 12, 2011
Last updated
Dec 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A123580 CA Primary

Addresses

Primary practice location

600 N Garfield Ave Ste 210
Monterey Park, CA 91754-1170

Mailing address

600 N Garfield Ave Ste 210
Monterey Park, CA 91754-1170
Phone (626) 573-8282

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
I20161028001570 CA Practitioner - General Surgery 0547548315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York Medical College, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

600 N Garfield Ave
Suite 210
Monterey Park, CA 91754-1170
Phone (626) 281-9111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A123580CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Minimally Invasive Surgical Services, Inc., an Osteopathic Corporation Surgery CurrentSince Sep 13, 2016 Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients
Ahmc Garfield Medical Center LP Past Accepting new patients
Ahmc Monterey Park Hospital LP Past Accepting new patients
Alhambra Hospital Medical Center, LP Past Accepting new patients
Ahmc Greater El Monte Comm Hosp LLC Past Accepting new patients

Locations

600 N Garfield Ave
Ste 210
Monterey Park, CA 91754
Phone (626) 281-9111

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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 5

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": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1457630055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N GARFIELD AVE STE 210",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541170",
            "telephone_number": "626-573-8282",
            "fax_number": "626-573-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N GARFIELD AVE STE 210",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541170",
            "telephone_number": "626-573-8282",
            "fax_number": "626-573-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SEAN",
        "middle_name": "YOUNGJIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-12",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A123580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

Verify at the official NPI Registry.