Organization Active NPI

Stanley S Kim MD, Inc

  • Ophthalmology Physician
  • Los Angeles, CA
National Provider Identifier
1598238784
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
STANLEY S KIM MD, INC
Practice address
3663 W 6TH St Ste 200
Los Angeles, CA 90020-3048
Phone
(213) 385-8500
Fax
(213) 385-4896
NPI assigned
Jan 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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

Authorized official

Name
Dr. Stanley S Kim, M.D.NPI 1003837840
Title
Owner
Phone
(213) 385-8500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

3663 W 6TH St Ste 200
Los Angeles, CA 90020-3048

Mailing address

3663 W 6TH St Ste 200
Los Angeles, CA 90020-3048
Phone (213) 385-8500

Other names 1

  • Stanley S Kim MD, Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190128002690 CA Part B Supplier - Clinic/Group Practice 7113264219 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

3663 W 6th St
Ste 200
Los Angeles, CA 90020
Phone (213) 385-8500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547078400000",
    "number": "1598238784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3663 W 6TH ST STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203048",
            "telephone_number": "213-385-8500",
            "fax_number": "213-385-4896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3663 W 6TH ST STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203048",
            "telephone_number": "213-385-8500",
            "fax_number": "213-385-4896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANLEY S KIM MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-385-8500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stanley S Kim MD, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.