Active NPI
Devin Kim
- Physical Therapist
- Fullerton, CA
National Provider Identifier
1568160778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 298773
- Practice address
- 2615 Trieste Way
Fullerton, CA 92833-2047 - Phone
- (714) 673-0083
- NPI assigned
- Feb 16, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 298773 | CA | Primary |
Addresses
Primary practice location
2615 Trieste Way
Fullerton, CA 92833-2047
Mailing address
2615 Trieste Way
Fullerton, CA 92833-2047
Phone (714) 673-0083
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 298773 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676505600000",
"number": "1568160778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2615 TRIESTE WAY",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928332047",
"telephone_number": "714-673-0083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2615 TRIESTE WAY",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928332047",
"telephone_number": "714-673-0083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "DEVIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-16",
"last_updated": "2023-02-16",
"certification_date": "2023-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "298773",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.