BMB Medical Group, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G64109 Issued in CA

Legal business name

BMB MEDICAL GROUP, INC

Practice address

4160 Wilshire Blvd
Suite 303
Los Angeles, CA 90010-3500

Phone

(323) 965-9650

Fax

(323) 965-9690

NPI assigned

Jan 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Walter J Kim, M.D.NPI 1497806566

Title

President

Phone

(323) 965-9650

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

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

• Walter J Kim I, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1497806566
  Medicare reassignment NPD Authorized official
• Gilbert Emile Faustina, MD

  • Surgery Physician
  • West Covina, CA
  • NPI 1558303271
  NPD (past)
• Job Li, MD

  • Internal Medicine Physician
  • North Hills, CA
  • NPI 1437293750
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394409600000",
    "number": "1700936374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 WILSHIRE BLVD",
            "address_2": "SUITE 303",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103500",
            "telephone_number": "323-965-9650",
            "fax_number": "323-965-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 WILSHIRE BLVD",
            "address_2": "SUITE 303",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900103500",
            "telephone_number": "323-965-9650",
            "fax_number": "323-965-9690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BMB MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2014-03-10",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-965-9650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G64109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, 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 10, 2014; 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.