Individual provider Active NPI

Eugene K. Kim, M.D.

  • Plastic Surgery Physician
  • Orange, CA
National Provider Identifier
1780864504
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
A99140 Issued in CA
Practice address
200 S Manchester Ave
Suite 650
Orange, CA 92868-3217
Phone
(714) 456-5755
Fax
(714) 456-7718
NPI assigned
Nov 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X A99140 CA Primary

Addresses

Primary practice location

200 S Manchester Ave
Suite 650
Orange, CA 92868-3217

Mailing address

200 S Manchester Ave
Suite 650
Orange, CA 92868-3217
Phone (714) 456-5755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A99140CAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bedford Anesthesia Inc. Current Accepting new patients
Eugene K Kim MD Inc Plastic Surgery PastSince Jun 1, 2010 Accepting new patients

Locations

436 N Bedford Dr
Ste 305
Beverly Hills, CA 90210
Phone (310) 246-9249

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1780864504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE",
            "address_2": "SUITE 650",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683217",
            "telephone_number": "714-456-5755",
            "fax_number": "714-456-7718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S MANCHESTER AVE",
            "address_2": "SUITE 650",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683217",
            "telephone_number": "714-456-5755",
            "fax_number": "714-456-7718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EUGENE",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A99140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.