Individual provider Active NPI

Hose Kim, M.D.

  • Surgery Physician
  • Whittier, CA
National Provider Identifier
1710107842
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G058070 Issued in CA
Practice address
6712 Friends Ave
Whittier, CA 90601-4432
Phone
(562) 945-8873
Fax
(562) 945-4324
NPI assigned
Apr 30, 2007
Last updated
Jul 15, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G058070 CA Primary

Addresses

Primary practice location

6712 Friends Ave
Whittier, CA 90601-4432

Mailing address

6712 Friends Ave
Whittier, CA 90601-4432
Phone (562) 945-8873

Other identifiers 1

IdentifierTypeStateIssuer
00G580700MedicaidCA

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060307000304 CA Practitioner - Orthopedic Surgery 7719994318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Virginia Commonwealth University, School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6712 Friends Ave
Whittier, CA 90601-4432

9080 Colima Rd
Whittier, CA 90605-1600
Phone (562) 945-3561

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
58070CAMDPharmacist
G058070CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hose Kim MD Inc Single Specialty CurrentSince Jan 7, 2002 Accepting new patients
Pacific Orthopaedic Medical Group, Inc. Single Specialty PastSince Jun 16, 2024 Accepting new patients
Pacific Orthopaedic Medical Group, Inc Single Specialty PastSince Jun 16, 2024 Accepting new patients

Locations

12600 Beach Blvd
Ste A1
Stanton, CA 90680
Phone (714) 894-7300

6712 Friends Ave
Whittier, CA 90601
Phone (562) 945-2161

7205 Greenleaf Ave
Ste B
Whittier, CA 90602
Phone (562) 945-8873

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247616000000",
    "number": "1710107842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6712 FRIENDS AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906014432",
            "telephone_number": "562-945-8873",
            "fax_number": "562-945-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6712 FRIENDS AVE",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906014432",
            "telephone_number": "562-945-8873",
            "fax_number": "562-945-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HOSE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-30",
        "last_updated": "2009-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "G058070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G580700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

Verify at the official NPI Registry.