Individual provider Active NPI

Jason Yonghoon Kim, M.D.

  • Pediatrics Physician
  • Torrance, CA
National Provider Identifier
1467411819
Registry record updated Dec 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G64108 Issued in CA
Practice address
3565 Del Amo Blvd Ste 200
Torrance, CA 90503-1637
Phone
(310) 214-0811
NPI assigned
Mar 22, 2006
Last updated
Dec 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G64108 CA Primary

Addresses

Primary practice location

3565 Del Amo Blvd Ste 200
Torrance, CA 90503-1637

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Other practice location 1

2232 Sepulveda Blvd
Torrance, CA 90501-5301
Phone (310) 257-2597

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
I20040503001529 CA Practitioner - Pediatric Medicine 0648268250 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G64108CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group CurrentSince Oct 1, 2024 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Oct 1, 2024 Accepting new patients
Memorial Medical Group Inc Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

2160 W 190th St
Torrance, CA 90504
Phone (310) 224-6943

2232 Sepulveda Blvd
Torrance, CA 90501
Phone (310) 257-2598

3242 Sepulveda Blvd
Torrance, CA 90505
Phone (310) 257-9300

3565 Del Amo Blvd
Torrance, CA 90503

3565 Del Amo Blvd
Ste 200
Torrance, CA 90503

Interoperability endpoints

  • Direct secure messaging: jkim206418@westdirect.optum.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766793600000",
    "number": "1467411819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3565 DEL AMO BLVD STE 200",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905031637",
            "telephone_number": "310-214-0811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2232 Sepulveda Blvd",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905015301",
            "country_code": "US",
            "telephone_number": "310-257-2597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "JASON",
        "middle_name": "YONGHOON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2025-12-27",
        "certification_date": "2025-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G64108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.