Charles Kim MD Inc

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

Legal business name

CHARLES KIM MD INC

Practice address

39717 Camino Mistral
Indio, CA 92203-4361

Phone

(497) 749-9994

Fax

(442) 268-1717

NPI assigned

Jul 23, 2019

Last updated

Dec 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hye Young Sung

Title

Medical Billing

Phone

(949) 527-9009

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1780237313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 N MAIN ST STE 100",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927056639",
            "telephone_number": "949-527-9009",
            "fax_number": "442-268-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39717 CAMINO MISTRAL",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922034361",
            "telephone_number": "497-749-9994",
            "fax_number": "442-268-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES KIM MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-23",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "SUNG",
        "authorized_official_first_name": "HYE YOUNG",
        "authorized_official_title_or_position": "MEDICAL BILLING",
        "authorized_official_telephone_number": "949-527-9009"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Maria Chavira, RI 504610423
• Lisa Chea, O.D.

• Adult Medicine Physician in Indio, CA
• Providers in Indio, CA by specialty
• Adult Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.