Active NPI
Ki-Yoon Kim, M.D.
- Gastroenterology Physician
- San Diego, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- A151164
- Practice address
- 4060 Fourth Avenue, Suite 240
San Diego, CA 92103 - Phone
- (619) 291-6064
- NPI assigned
- Apr 20, 2016
- Last updated
- Oct 2, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 315245 | NY | |
| Gastroenterology Physician | 207RG0100X | A151164 | CA | Primary |
Addresses
Primary practice location
4060 Fourth Avenue, Suite 240
San Diego, CA 92103
Mailing address
4060 Fourth Ave Ste 240
San Diego, CA 92103-2120
Phone (619) 291-6064
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| KK3232267556 | Medicaid | CA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Rutgers New Jersey Medical School, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Tustin, CA 92780
Phone (714) 987-1121
1025 S Anaheim Blvd
Anaheim, CA 92805-5806
Phone (714) 987-1121
1111 W la Palma Ave
Anaheim, CA 92801-2804
Phone (714) 987-1121
1211 W la Palma Ave
Suite 404
Anaheim, CA 92801-2806
Phone (714) 772-8282
4060 4TH Ave
Suite 240
San Diego, CA 92103-2120
Phone (619) 291-6064
4077 5TH Ave
San Diego, CA 92103-2105
Phone (619) 359-6600
Hospital & facility affiliations
- Ace Home Health, Inc.
- Ahmc Anaheim Regional Medical Center
- Scripps Mercy Hospital
- Coastal Communities Hospital
- Anaheim Global Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.8 of 100
- Quality
- 91.79
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.18
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 113 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 189 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A151164 | CA | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kyk Medical Professional Corporation | Gastroenterology | Current | Accepting new patients |
| Family Health Centers of San Diego Inc | Current | Accepting new patients | |
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| Family Health Centers of San Diego, Inc | Current | Accepting new patients | |
| Scripps Health | Current | Accepting new patients | |
| Chest and Critical Care Consultants a Medical Group | Current | Accepting new patients | |
| Chest and Critical Care Consultants | Current | Accepting new patients | |
| On Call Specialists Medical Group of San Diego, Inc. | Current | Accepting new patients |
Locations
1211 W La Palma Ave
Ste 404
Anaheim, CA 92801
Phone (714) 772-1030
1211 W La Palma Ave
Ste 709
Anaheim, CA 92801
Phone (714) 808-9292
4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245
4094 4th Ave
San Diego, CA 92103
Phone (619) 515-2545
823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323
13522 Newport Ave
Ste 102
Tustin, CA 92780
Phone (714) 573-8200
650 E Devon Ave
Ste 165
Itasca, IL 60143
Phone (630) 285-1040
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- BSC 65 PLUS INDIVIDUAL MAPD
- Healthfirst Medicare Network H3359
Interoperability endpoints
- kkim286578@scrippshlth.medalliesdirect.net
Organizations & group practices 9
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.
-
dba Family Health Center of La Palma
- Internal Medicine Physician
- Anaheim, CA
- NPI 1598852717
-
dba Kyk Medical, Inc
- Gastroenterology Physician
- Tustin, CA
- NPI 1093502148
-
- Specialist
- San Diego, CA
- NPI 1962175836
-
dba Denison, Goodman, Epsten & Haynes Medical Corporation
- Gastroenterology Physician
- San Diego, CA
- NPI 1578621199
-
dba Logan Heights Family Health Center
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1447281936
-
dba Southern California Sleep Disorders Specialists
- Sleep Disorder Diagnostic Clinic/Center
- Tustin, CA
- NPI 1659450054
-
dba FamilyHealth on Commercial
- Federally Qualified Health Center (FQHC)
- San Diego, CA
- NPI 1235521782
-
dba Escondido Physical Health and Wellness
- Federally Qualified Health Center (FQHC)
- Escondido, CA
- NPI 1356178180
-
dba Scripps Hospital Medical Services
- General Acute Care Hospital
- San Diego, CA
- NPI 1487928891
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Los Angeles, CA
- NPI 1205808326
-
dba AHMC Anaheim Regional Medical Center
- General Acute Care Hospital
- Anaheim, CA
- NPI 1891938122
-
dba Anaheim Global Medical Center
- General Acute Care Hospital
- Anaheim, CA
- NPI 1790778488
-
dba South Coast Global Medical Center
- General Acute Care Hospital
- Santa Ana, CA
- NPI 1558354258
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790899200000",
"number": "1558715110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4060 FOURTH AVE STE 240",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921032120",
"telephone_number": "619-291-6064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4060 FOURTH AVENUE, SUITE 240",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92103",
"telephone_number": "619-291-6064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "KI-YOON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-20",
"last_updated": "2026-10-02",
"certification_date": "2026-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "NY",
"license": "315245",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "CA",
"license": "A151164",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "KK3232267556",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
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 Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.