John Kim, M.D.a Professional Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G66684 Issued in CA

Legal business name

JOHN KIM, M.D.A PROFESSIONAL CORPORATION

Practice address

1433 W Merced Ave
Suit #311
West Covina, CA 91790-3402

Phone

(626) 960-3066

NPI assigned

Apr 25, 2014

Organization subpart

No

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

Authorized official

Name

Mr. John S. Kim, M.D.NPI 1003991159

Title

President

Phone

(562) 402-7622

Specialties & licenses 1

Addresses

Other names 1

• Angeles Healthcare WC, LLC Doing business as

Practitioners 1

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

• John Shin Kim, M.D.

  • Family Medicine Physician
  • Cerritos, CA
  • NPI 1003991159
  NPD (past) Authorized official

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

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398384000000",
    "number": "1780004010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11911 ARTESIA BLVD",
            "address_2": "SUIT #101",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907014065",
            "telephone_number": "562-402-7622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 W MERCED AVE",
            "address_2": "SUIT #311",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903402",
            "telephone_number": "626-960-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN KIM, M.D.A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-25",
        "last_updated": "2014-04-25",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "562-402-7622",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G66684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angeles Healthcare WC, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sergio Jimenez
• Stephanie Jimenez
• JJ Wang Dental Corp.
• JJJ Acupuncture
• Jo Mi Icf DDN Facilities
• John Lindberg, M.D., Inc.
• John Morales Mental Health
• John Z Wang MD Inc
• Clarissa Joy Johnson
• Jazmine Johnson

• Family Medicine Physician in West Covina, CA
• Providers in West Covina, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; 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.