Ilkwon Kim, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

C50652 Issued in CA

Practice address

412 S Wilton PL Apt 402
Los Angeles, CA 90020-4586

Phone

(121) 380-0101

Fax

(213) 800-1010

NPI assigned

Feb 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1639141773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 S. WILTON PLACE",
            "address_2": "UNIT 402",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90020",
            "telephone_number": "12138001010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 S WILTON PL APT 402",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900204586",
            "telephone_number": "121-380-0101",
            "fax_number": "213-800-1010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2630 San Gabriel Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Rosemead",
            "state": "CA",
            "postal_code": "917705204",
            "country_code": "US",
            "telephone_number": "626-280-9968",
            "fax_number": "877-400-0565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "ILKWON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "C50652",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "C50652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "D3254925",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hyunseok Kim, MD
• Hyunsik Kim
• Hyunyoung Kim, MS CCC-SLP
• Il Young Kim, M.D.
• Ilhyung Kim, L.AC
• In Kang Kim
• Inchul Kim
• Injib J. Kim, MD
• Inkwon Kim, D.D.S.
• Insoo Kim, DC

• Diagnostic Radiology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.

Verify at the official NPI Registry.