Paul Seung Ki Kim, M.D.

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

A114242 Issued in CA

Practice address

1950 S Sunwest LN
Ste 108
San Bernardino, CA 92408-3263

Phone

(909) 521-8818

Fax

(909) 521-9854

NPI assigned

Apr 1, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Cal City Urgent Care

  • Urgent Care Clinic/Center
  • California City, CA
  • NPI 1659092997

  Occupational Medicine

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686441600000",
    "number": "1710129093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 S SUNWEST LN",
            "address_2": "STE 108",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083263",
            "telephone_number": "909-521-8818",
            "fax_number": "909-521-9854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 S SUNWEST LN",
            "address_2": "STE 108",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083263",
            "telephone_number": "909-521-8818",
            "fax_number": "909-521-9854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8100 California City Blvd",
            "address_purpose": "LOCATION",
            "city": "California City",
            "state": "CA",
            "postal_code": "935052648",
            "country_code": "US",
            "telephone_number": "818-651-6608",
            "fax_number": "818-584-2703",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17310 Bear Valley Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923957773",
            "country_code": "US",
            "telephone_number": "909-453-3255",
            "fax_number": "909-521-9854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "PAUL",
        "middle_name": "SEUNG KI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-01",
        "last_updated": "2023-06-11",
        "certification_date": "2023-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A114242",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CA",
            "license": "A114242",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A114242",
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CA",
            "license": "A114242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hyun June Kim, DDS
• Jeffrey J Kim, DDS
• Jiyeon Kim, L.AC
• Jungbum Kim
• Katie Y. Kim
• Prisca Kim
• Soodong Kim, D.D.S.
• Stephanie Mijoo Kim
• Sun Ik Kim, MD
• Sunny Eun Kim

• Public Health & General Preventive Medicine Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Public Health & General Preventive Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2023; 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.