Youjeong Kim, M.D., Inc

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

A82293 Issued in CA

Legal business name

YOUJEONG KIM, M.D., INC

Practice address

2100 Webster St Ste 117
San Francisco, CA 94115-2374

Phone

(415) 775-1095

Fax

(415) 775-1085

NPI assigned

Feb 19, 2014

Organization subpart

No

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

Authorized official

Name

Youjeong Kim, M.D.NPI 1295753309

Title

Ceo

Phone

(415) 775-1095

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

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

• Youjeong Kim, MD

  • Orthopaedic Surgery Physician
  • San Francisco, CA
  • NPI 1295753309

  Orthopaedic Surgery of the Spine

  Medicare reassignment Care Compare group NPD Authorized official
• Brianna Pivo Smith, PA-C

  • Physician Assistant
  • San Francisco, CA
  • NPI 1750044178
  Medicare reassignment Care Compare group
• Cheryl Shirley, PA-C

  • Physician Assistant
  • Sacramento, CA
  • NPI 1992231559
  Medicare reassignment

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592438400000",
    "number": "1720403348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 WEBSTER ST STE 117",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941152374",
            "telephone_number": "415-775-1095",
            "fax_number": "415-775-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 WEBSTER ST STE 117",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941152374",
            "telephone_number": "415-775-1095",
            "fax_number": "415-775-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUJEONG KIM, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-19",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "YOUJEONG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-775-1095",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "A82293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Young Men'S Christian Association of San Francisco

• Orthopaedic Surgery of the Spine Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Orthopaedic Surgery of the Spine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; 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.