Active NPI
Paul Han Soo Kim, M.D.
- Family Medicine Physician
- Walnut Creek, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G86124
- Practice address
- 2637 Shadelands Dr
Walnut Creek, CA 94598-2512 - Phone
- (925) 288-2828
- Fax
- (925) 288-0829
- NPI assigned
- Apr 19, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G86124 | CA | Primary |
Addresses
Primary practice location
2637 Shadelands Dr
Walnut Creek, CA 94598-2512
Mailing address
2637 Shadelands Dr
Walnut Creek, CA 94598-2512
Phone (925) 288-2828
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bass Medical Group | Current | Accepting new patients | |
| Bay Area Surgical Specialists, Inc a Medical Corporation | Current | Accepting new patients | |
| Bass Medical Group | Family Medicine | Current | Accepting new patients |
| John Muir Health | Past | Accepting new patients | |
| Torrance Memorial Medical Center | Past | Accepting new patients | |
| Bass Medical Group | Past | Accepting new patients | |
| John Muir Health | Past | Accepting new patients |
Locations
1505 Saint Alphonsus Way
Alamo, CA 94507
Phone (925) 837-4225
1776 Ygnacio Valley Rd
Ste 208
Walnut Creek, CA 94598
Phone (925) 937-0995
1776 Ygnacio Valley Rd
Ste 201
Walnut Creek, CA 94598
Phone (925) 288-0828
365 Lennon Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 627-3424
2637 Shadelands Dr
Walnut Creek, CA 94598
Phone (925) 627-3424
Organizations & group practices 7
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.
-
- Obstetrics & Gynecology Physician
- Walnut Creek, CA
- NPI 1174253405
Family Medicine
-
- Orthopaedic Surgery Physician
- San Ramon, CA
- NPI 1467329904
-
- Orthopaedic Surgery Physician
- Sacramento, CA
- NPI 1356702526
-
- Specialist
- Walnut Creek, CA
- NPI 1154401941
-
- Rehabilitation Hospital Unit
- Walnut Creek, CA
- NPI 1447269303
-
- General Acute Care Hospital
- Concord, CA
- NPI 1801821376
-
- Skilled Nursing Facility
- Torrance, CA
- NPI 1740268713
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741046400000",
"number": "1609831163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2637 SHADELANDS DR",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945982512",
"telephone_number": "925-288-2828",
"fax_number": "925-288-0829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2637 SHADELANDS DR",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945982512",
"telephone_number": "925-288-2828",
"fax_number": "925-288-0829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "PAUL",
"middle_name": "HAN SOO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-19",
"last_updated": "2025-03-04",
"certification_date": "2025-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G86124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.