Sally I. Kim, M.D., Inc.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G57460 Issued in CA

Legal business name

SALLY I. KIM, M.D., INC.

Practice address

5972 Beach Blvd
Buena Park, CA 90621-2024

Phone

(714) 562-5857

Fax

(714) 562-8717

NPI assigned

Feb 1, 2008

Organization subpart

No

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

Authorized official

Name

Sally Inja Kim, M.D.

Title

President

Phone

(714) 562-5857

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Inja Kim, M.D.

  • Ophthalmology Physician
  • Buena Park, CA
  • NPI 1588762769
  Medicare reassignment NPD

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591574400000",
    "number": "1699953695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5972 BEACH BLVD",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906212024",
            "telephone_number": "714-562-5857",
            "fax_number": "714-562-8717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5972 BEACH BLVD",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906212024",
            "telephone_number": "714-562-5857",
            "fax_number": "714-562-8717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALLY I. KIM, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-01",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "INJA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-562-5857",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G57460",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marliza Sagum
• Salamati & Zahed Medical Corp
• Joyce Christine Salas, PHARM.D.
• Mark Anthony Panganiban Salazar, PTA
• Joseff Sales
• Mercedes Blasco Samson, M.D.
• Donna Liza T Sanchez, NP-C
• Sarah Lucas Sanchez, M.S. CCC-SLP
• Sasha Sanders Castro
• Sang DO Lee Chiropractic

• Ophthalmology Physician in Buena Park, CA
• Providers in Buena Park, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.