Active NPI
Young S Kim
- Specialist
- San Francisco, CA
National Provider Identifier
1679507214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- G11151
- Practice address
- 4150 Clement St
San Francisco, CA 94121-1545 - Phone
- (415) 750-2095
- Fax
- (415) 750-6972
- NPI assigned
- Jul 10, 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 |
|---|---|---|---|---|
| Specialist | 174400000X | G11151 | CA | Primary |
Addresses
Primary practice location
4150 Clement St
San Francisco, CA 94121-1545
Mailing address
4150 Clement St.
San Francisco, CA 94121
Phone (415) 750-2095
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G11151 | Other | CA | MEDICAL LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G11151 | CA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679507214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4150 CLEMENT ST.",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "94121",
"telephone_number": "415-750-2095",
"fax_number": "415-750-6972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4150 CLEMENT ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941211545",
"telephone_number": "415-750-2095",
"fax_number": "415-750-6972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "YOUNG",
"middle_name": "S",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "G11151",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "G11151",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.