Individual provider Active NPI

Booil Kim, D.O.

  • General Practice Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1508250804
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
20A14985 Issued in CA
Practice address
9405 Fairway View PL
Rancho Cucamonga, CA 91730-0932
Phone
(909) 481-7345
NPI assigned
Mar 25, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 20A14985 CA
General Practice Physician 208D00000X 20A14985 CA Primary

Addresses

Primary practice location

9405 Fairway View PL
Rancho Cucamonga, CA 91730-0932

Mailing address

9405 Fairway View PL
Rancho Cucamonga, CA 91730-0932

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
I20220705001694 CA Practitioner - General Practice 1254711575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care of California a Medical CorporationGroup PAC ID 5799854303, 135 clinicians

Practice addresses (Care Compare)

9405 Fairway View PL
Rancho Cucamonga, CA 91730-0932
Phone (909) 481-7345

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A14985CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of California, a Medical Corporation Single Specialty Current Accepting new patients
American Current Care of California, a Medical Corporation Single Specialty CurrentSince Jul 18, 2022 Accepting new patients
American Current Care of California, a Medical Corporation Single Specialty CurrentSince Jul 18, 2022 Accepting new patients

Locations

1800 Westwind Dr
Ste 301
Bakersfield, CA 93301
Phone (661) 327-9617

2555 S East Ave
Fresno, CA 93706
Phone (559) 499-2400

15751 Rockfield Blvd
Irvine, CA 92618
Phone (949) 206-9100

1340 Mitchell Rd
Modesto, CA 95351
Phone (209) 581-9711

25115 Madison Ave
Murrieta, CA 92562
Phone (951) 600-9070

1101 S Milliken Ave
Ste C
Ontario, CA 91761
Phone (909) 390-2799

1851 Lombard St
Ste 100
Oxnard, CA 93030
Phone (805) 983-2234

640 S Placentia Ave
Placentia, CA 92870
Phone (714) 579-7772

9405 Fairway View Pl
Rancho Cucamonga, CA 91730
Phone (909) 481-7345

2 Connecticut St
San Francisco, CA 94107
Phone (415) 621-5055

2587 Merced St
San Leandro, CA 94577
Phone (510) 351-3553

740 Nordahl Rd
Ste 131
San Marcos, CA 92069
Phone (760) 432-9000

988 Walsh Ave
Santa Clara, CA 95050
Phone (408) 988-6868

1221 N Dutton Ave
Santa Rosa, CA 95401
Phone (707) 543-8360

3 S Linden Ave
South San Francisco, CA 94080
Phone (650) 238-1500

3663 Arch Rd
Ste 400
Stockton, CA 95215
Phone (209) 943-2202

21081 S Western Ave
Ste 150
Torrance, CA 90501
Phone (310) 782-3333

3680 Industrial Blvd
Ste 550H
West Sacramento, CA 95691
Phone (916) 373-7575

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1508250804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9405 FAIRWAY VIEW PL",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9405 FAIRWAY VIEW PL",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300932",
            "telephone_number": "909-481-7345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "BOOIL",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-25",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A14985",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A14985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.