Young Song Kim, MD, Inc.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

C36986 Issued in CA

Legal business name

YOUNG SONG KIM, MD, INC.

Practice address

80539 Pebble BCH
La Quinta, CA 92253-4627

Phone

(760) 564-0241

Fax

(760) 564-5941

NPI assigned

Sep 22, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Young Song Kim, M.D.

Title

President

Phone

(760) 564-0241

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548360399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80539 PEBBLE BCH",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534627",
            "telephone_number": "760-564-0241",
            "fax_number": "760-564-5941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80539 PEBBLE BCH",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922534627",
            "telephone_number": "760-564-0241",
            "fax_number": "760-564-5941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG SONG KIM, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "YOUNG SONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-564-0241",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "C36986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in La Quinta, CA
• Providers in La Quinta, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.