NPIMap

Individual provider Active NPI

Diana Maria Kim, M.D.

  • Cardiovascular Disease Physician
  • Los Angeles, CA
National Provider Identifier
1780811844
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
A112970 Issued in CA
Practice address
3919 Beverly Blvd
#100
Los Angeles, CA 90004-3432
Phone
(323) 662-1175
NPI assigned
Jun 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 252607-1 NY
Cardiovascular Disease Physician 207RC0000X A112970 CA Primary

Addresses

Primary practice location

3919 Beverly Blvd
#100
Los Angeles, CA 90004-3432

Mailing address

3919 Beverly Blvd
#100
Los Angeles, CA 90004-3432
Phone (323) 662-1175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130820000277 CA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Diagnostic RadiologyPractitioner - Preventive Medicine 1759523897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Diagnostic Radiology, Internal Medicine, Preventive Medicine
Education
Albany Medical College of Union University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3919 Beverly Blvd
Suite 100
Los Angeles, CA 90004-3432
Phone (323) 662-1175

Hospital & facility affiliations

  • Pih Health Good Samaritan Hospital Hospital, Los Angeles, CA, CCN 050471
  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
252607-1NYMDInternal Medicine Physician
A112970CAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beverly Cardiology Group Cardiovascular Disease CurrentSince Jun 28, 2013 Accepting new patients
Good Samaritan Hospital Ca LTD PTP Past Accepting new patients
Dignity Community Care Past Accepting new patients
Good Samaritan Hospital of Suffern Past Accepting new patients
Cha Hollywood Medical Center, LP Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients
Pih Health Good Samaritan Hospital Past Accepting new patients

Locations

3919 Beverly Blvd
Ste 100
Los Angeles, CA 90004
Phone (213) 662-1175

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1780811844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 BEVERLY BLVD",
            "address_2": "#100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043432",
            "telephone_number": "323-662-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 BEVERLY BLVD",
            "address_2": "#100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043432",
            "telephone_number": "323-662-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DIANA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-16",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "252607-1",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A112970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.