Jae M Kim, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A38835 Issued in CA

Practice address

1433 W Merced Ave.
Suite 217
West Covina, CA 91790-5058

Phone

(626) 917-1924

Fax

(626) 337-8434

NPI assigned

Dec 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205452800000",
    "number": "1689735953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1433 W MERCED AVE.",
            "address_2": "SUITE 217",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917905058",
            "telephone_number": "626-917-1924",
            "fax_number": "626-337-8434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 W MERCED AVE.",
            "address_2": "SUITE 217",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917905058",
            "telephone_number": "626-917-1924",
            "fax_number": "626-337-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JAE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2008-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A38835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A388350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aileen Kim, D.D.S., M.S.
• Betty Kim
• Choon Kyung Kim, D.D.S.
• Eunsun Kim
• Heidi Weizhang Kim, DDS
• Jennifer Young Kim, MD
• Jeong E. Kim, DDS
• Jung Hoon Kim, PHARM.D.
• Stella Kim
• Young Woo Kim, DDS

• Internal Medicine Physician in West Covina, CA
• Providers in West Covina, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.