Individual provider Active NPI

Xander Hanjune Kim, DPM

  • Foot & Ankle Surgery Podiatrist
  • San Francisco, CA
National Provider Identifier
1790460335
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
EL7108 Issued in CA
Practice address
4150 Clement St
San Francisco, CA 94121-1563
Phone
(415) 221-4810
NPI assigned
Jun 20, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X EL7108 CA Primary

Addresses

Primary practice location

4150 Clement St
San Francisco, CA 94121-1563

Mailing address

4150 Clement St
San Francisco, CA 94121-1563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2182 E St
Concord, CA 94520-2012

3330 Clayton Rd
Suite B
Concord, CA 94519-2894

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
EL7108CAMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1790460335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 CLEMENT ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 CLEMENT ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211563",
            "telephone_number": "415-221-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "XANDER",
        "middle_name": "HANJUNE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "EL7108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.