Active NPI
Brendan Kim
- Rehabilitation Practitioner
- Redwood, CA
National Provider Identifier
1700617206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 240 Edmonds Rd., Building D
Redwood, CA 94062 - Phone
- (510) 679-4254
- NPI assigned
- Aug 8, 2024
- Last updated
- Dec 24, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | NU | Primary | |
| Case Manager/Care Coordinator | 171M00000X | NU |
Addresses
Primary practice location
240 Edmonds Rd., Building D
Redwood, CA 94062
Mailing address
240 Edmonds Rd., Building D
Redwood, CA 94062
Phone (510) 679-4254
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766534400000",
"number": "1700617206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 EDMONDS RD., BUILDING D",
"city": "REDWOOD",
"state": "CA",
"postal_code": "94062",
"telephone_number": "510-679-4254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 EDMONDS RD., BUILDING D",
"city": "REDWOOD",
"state": "CA",
"postal_code": "94062",
"telephone_number": "510-679-4254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "BRENDAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-08-08",
"last_updated": "2025-12-24",
"certification_date": "2025-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.