Individual provider Active NPI

Chong U Kim, MD

  • Internal Medicine Physician
  • Torrance, CA
National Provider Identifier
1528034485
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A54806 Issued in CA
Practice address
23560 Madison St Ste 204
Torrance, CA 90505-4710
Phone
(424) 328-0203
NPI assigned
Feb 28, 2006
Last updated
Oct 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A54806 CA Primary

Addresses

Primary practice location

23560 Madison St Ste 204
Torrance, CA 90505-4710

Mailing address

PO Box 66596
Seattle, WA 98166-0596
Phone (424) 328-0203

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
I20060320000730 CA Practitioner - Internal Medicine 9436166238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Hahnemann University College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

23560 Madison St
Suite 204
Torrance, CA 90505-4710
Phone (310) 373-1253

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A54806CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chong U Kim MD Inc Internal Medicine CurrentSince Mar 1, 2007 Accepting new patients

Locations

23430 Hawthorne Blvd
Ste 325
Torrance, CA 90505
Phone (310) 649-2658

23560 Madison St
Ste 204
Torrance, CA 90505
Phone (310) 373-1253

Interoperability endpoints

  • Direct secure messaging: chongukimmdinc.chongkim@129546.advancedmd-direct.com

Organizations & group practices 1

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 7

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1528034485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66596",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981660596",
            "telephone_number": "424-328-0203",
            "fax_number": "424-328-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23560 MADISON ST STE 204",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905054710",
            "telephone_number": "424-328-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHONG",
        "middle_name": "U",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A54806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.