Organization Active NPI

Paul E Kim MD Inc

Doing business as Meta Sports and Pain Medicine

  • Pain Medicine (Anesthesiology) Physician
  • San Diego, CA
National Provider Identifier
1497875363
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
A63939 Issued in CA
Legal business name
PAUL E KIM MD INC
Doing business as
Meta Sports and Pain Medicine
Paul Kim MD Pain Management
Practice address
8352 Clairemont Mesa Blvd Ste a
San Diego, CA 92111-1302
Phone
(619) 543-0144
Fax
(619) 543-0445
NPI assigned
Apr 2, 2007
Last updated
Dec 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Authorized official

Name
Dr. Paul Euin Kim, MDNPI 1871517110
Title
Medical Director
Phone
(619) 543-0144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X A63939 CA Primary

Addresses

Primary practice location

8352 Clairemont Mesa Blvd Ste a
San Diego, CA 92111-1302

Mailing address

8352 Clairemont Mesa Blvd Ste a
San Diego, CA 92111-1302
Phone (619) 543-0144

Other practice location 1

3549 Camino Del Rio S
Ste A
San Diego, CA 92108-4023
Phone (619) 543-0144

Other names 2

  • Meta Sports and Pain Medicine Doing business as
  • Paul Kim MD Pain Management Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050317000402 CA Part B Supplier - Clinic/Group Practice 1052366531 Receives reassigned benefits from 3 practitioners
Practice locations: San Diego, CA
O20120220000421 CA DME Supplier - Physician - Unknown Physician Specialty 1052366531 Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

940 E Valley Pkwy
Ste N
Escondido, CA 92025
Phone (760) 546-0442

9900 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

3023 Bunker Hill St
Ste 201
San Diego, CA 92109
Phone (619) 548-6733

3549 Camino del Rio S
Ste A
San Diego, CA 92108
Phone (619) 543-0144

8352 Clairemont Mesa Blvd
Ste A
San Diego, CA 92111
Phone (619) 543-0144

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBHBDA

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1497875363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8352 CLAIREMONT MESA BLVD STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111302",
            "telephone_number": "619-543-0144",
            "fax_number": "619-543-0445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8352 CLAIREMONT MESA BLVD STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921111302",
            "telephone_number": "619-543-0144",
            "fax_number": "619-543-0445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3549 Camino Del Rio S",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921084023",
            "country_code": "US",
            "telephone_number": "619-543-0144",
            "fax_number": "619-543-0445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAUL E KIM MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "EUIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "619-543-0144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A63939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meta Sports and Pain Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Paul Kim MD Pain Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.