Individual provider Active NPI

Sang You Kim, M.D.

  • General Practice Physician
  • Chino Hills, CA
National Provider Identifier
1568494367
Registry record updated Jan 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A41877 Issued in CA
Practice address
14273 Ruby Glen CT
Chino Hills, CA 91709-5915
Phone
(714) 351-1418
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A41877 CA Primary

Addresses

Primary practice location

14273 Ruby Glen CT
Chino Hills, CA 91709-5915

Mailing address

14273 Ruby Glen CT
Chino Hills, CA 91709-5915
Phone (714) 351-1418

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Medical Group, Inc. General Practice Past Accepting new patients
Sang Y. Kim, M.D., Inc. General Practice PastSince Mar 8, 2005 Accepting new patients
Shalom Medical Group, Inc. Past Accepting new patients
Whan Sil Kim, M.D., Inc. Past Accepting new patients
Art Physical Therapy Past Accepting new patients

Organizations & group practices 5

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389830400000",
    "number": "1568494367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14273 RUBY GLEN CT",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917095915",
            "telephone_number": "714-351-1418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14273 RUBY GLEN CT",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917095915",
            "telephone_number": "714-351-1418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SANG",
        "middle_name": "YOU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2014-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A41877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; 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.