Michael John Kimball, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

523970 Issued in CA

Practice address

2501 Harbor Blvd
Costa Mesa, CA 92626-6143

Phone

(714) 957-5000

NPI assigned

May 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• State of California - Department of Developmental Services

  • General Acute Care Hospital
  • Pomona, CA
  • NPI 1154372498
  Medicare reassignment NPD
• Agnews Community Clinic

  • Developmental Disabilities Clinic/Center
  • San Jose, CA
  • NPI 1710148515
  NPD
• State of California - Department of Developmental Services

  • General Acute Care Hospital
  • Costa Mesa, CA
  • NPI 1225089592
  NPD
• State of California - Department of Developmental Services

  • General Acute Care Hospital
  • Eldridge, CA
  • NPI 1851344220
  NPD
• State of California - Department of Developmental Services

  • Federally Qualified Health Center (FQHC)
  • Pomona, CA
  • NPI 1093085565
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1700838646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 9TH STREET",
            "address_2": "ROOM 205 MAILSTOP 2-3",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958146414",
            "telephone_number": "916-654-2431",
            "fax_number": "916-654-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 HARBOR BLVD",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926266143",
            "telephone_number": "714-957-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBALL",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "523970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rheela Kim, O.D.
• Sally Kim
• Sean Sunghak Kim, PT, DPT
• Stephanie J Kim
• Tiffany Virginia Francisco Kim, BCBA
• Mekhi Kimble
• Jeanne Diane Kimura, PSYD
• Kindred Communication Inc.
• Donald Dean King, DDS
• Jordin King

• Adult Health Nurse Practitioner in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Adult Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.