Individual provider Active NPI

Jungmee Kim, M.D.

  • Allergy & Immunology Physician
  • La Mirada, CA
National Provider Identifier
1669465225
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
A046017 Issued in CA
Practice address
15040 Imperial Hwy
La Mirada, CA 90638-1301
Phone
(562) 902-1014
Fax
(562) 902-1015
NPI assigned
Aug 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X A046017 CA
Allergy & Immunology Physician 207K00000X A046017 CA Primary
Allergy & Immunology (Internal Medicine) Physician 207RA0201X A046017 CA

Addresses

Primary practice location

15040 Imperial Hwy
La Mirada, CA 90638-1301

Mailing address

15040 Imperial Hwy
La Mirada, CA 90638-1301
Phone (562) 902-1014

Other identifiers 1

IdentifierTypeStateIssuer
953063755OtherCATAX ID #

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100112000096 CA Practitioner - Allergy/Immunology 6709926645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15040 Imperial Hwy
La Mirada, CA 90638-1301
Phone (562) 902-1014

Hospital & facility affiliations

  • Pih Health Hospital-Whittier Hospital, Whittier, CA, CCN 050169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46017CAMDGeneral Practice Dentistry
A046017CAMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louis E. Marchioli, M.D., Inc Allergy & Immunology CurrentSince Jan 1, 1991 Accepting new patients
Pih Health Whittier Hospital Past Accepting new patients

Locations

15040 Imperial Hwy
La Mirada, CA 90638
Phone (562) 902-1014

15141 Whittier Blvd
Ste 480
Whittier, CA 90603
Phone (562) 698-3776

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1669465225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15040 IMPERIAL HWY",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381301",
            "telephone_number": "562-902-1014",
            "fax_number": "562-902-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15040 IMPERIAL HWY",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381301",
            "telephone_number": "562-902-1014",
            "fax_number": "562-902-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JUNGMEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-29",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CA",
            "license": "A046017",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "A046017",
            "primary": true
        },
        {
            "code": "207RA0201X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Allergy & Immunology",
            "state": "CA",
            "license": "A046017",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "953063755",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mirada, CA

Sources for this page

Verify at the official NPI Registry.