Khijoo Kim, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A145961 Issued in CA

Practice address

805 W la Veta Ave Ste 110
Orange, CA 92868-3933

Phone

(714) 289-8800

Fax

(714) 633-9928

NPI assigned

Apr 27, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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.

• New Light Medical Group, Inc.

  • Health Maintenance Organization
  • Anaheim, CA
  • NPI 1912133364
  NPD (past)
• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  NPD (past)
• Ron Javdan MD LLC

  • Internal Medicine Physician
  • Chesterfield, MO
  • NPI 1578824256
  NPD (past)

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1770960809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 CRENSHAW BLVD STE 100",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905012055",
            "telephone_number": "323-732-0100",
            "fax_number": "424-558-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W LA VETA AVE STE 110",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683933",
            "telephone_number": "714-289-8800",
            "fax_number": "714-633-9928"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 96th St",
            "address_2": "Apt 1G",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112097548",
            "country_code": "US",
            "telephone_number": "202-763-1571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 W Romneya Dr Ste 606",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928011828",
            "country_code": "US",
            "telephone_number": "714-635-0600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "760 Washburn Ave Ste 21",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928823303",
            "country_code": "US",
            "telephone_number": "951-734-8000",
            "fax_number": "951-734-8096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "KHIJOO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A145961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juri Kim
• Kate Kim
• Ken Sangboem Kim
• Kenneth Kim, M.D
• Kenneth C Kim, DO
• Kristin Kim, FNP
• Krystal Yuri Kim
• Leslie Jinha Kim
• Lisa Kim, NP
• Manyong Kim, D.D.S.

• Pediatrics Physician in Orange, CA
• Providers in Orange, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.