Active NPI
Jieun Anna Kim, M.D.
- Ophthalmology Physician
- San Diego, CA
National Provider Identifier
1720305584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- A115677
- Practice address
- 3030 Childrens Way
Suite 109
San Diego, CA 92123-4232 - Phone
- (858) 309-7702
- NPI assigned
- May 3, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | A115677 | CA | Primary |
Addresses
Primary practice location
3030 Childrens Way
Suite 109
San Diego, CA 92123-4232
Mailing address
3020 Childrens Way
MC 5003
San Diego, CA 92123-4223
Phone (858) 309-6300
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115677 | CA | MD | Clinical Social Worker |
| A115677 | CA | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marilyn Kaufhold, M.D., a Medical Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Children's Hospital
- San Diego, CA
- NPI 1336359389
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493856000000",
"number": "1720305584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3020 CHILDRENS WAY",
"address_2": "MC 5003",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234223",
"telephone_number": "858-309-6300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3030 CHILDRENS WAY",
"address_2": "SUITE 109",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234232",
"telephone_number": "858-309-7702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JIEUN",
"middle_name": "ANNA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-03",
"last_updated": "2017-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "A115677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.