Heebok Kim, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

C42386 Issued in CA

Practice address

1998 N Arrowhead Ave
San Bernardino, CA 92405-4116

Phone

(909) 882-0988

Fax

(909) 886-1301

NPI assigned

Oct 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Dignity Health

  • General Acute Care Hospital
  • San Bernardino, CA
  • NPI 1689769911
  NPD (past)
• Primary Care Medical Group of Inland Empire, Inc

  • Multi-Specialty Clinic/Center
  • San Bernardino, CA
  • NPI 1255412474
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1730260910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1998 N ARROWHEAD AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924054116",
            "telephone_number": "909-882-0988",
            "fax_number": "909-886-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1998 N ARROWHEAD AVE",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924054116",
            "telephone_number": "909-882-0988",
            "fax_number": "909-886-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "HEEBOK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "C42386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C152370",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dae Yeon Kim, FNP-C
• Daniel Kim, P.A.
• Daniel E Kim, PA-C
• Gregory Young Kim, BA
• Han You Kim, DDS
• Hye Seung Kim
• Hyun June Kim, DDS
• Jeffrey J Kim, DDS
• Jiyeon Kim, L.AC
• Jungbum Kim

• Specialist in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.