Active NPI
Hernan Kim, PT, DPT
- Physical Therapist
- Alameda, CA
National Provider Identifier
1801339841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT292059
- Practice address
- 1700 Park St
Suite #200
Alameda, CA 94501-1571 - Phone
- (510) 521-5900
- NPI assigned
- Nov 23, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT292059 | CA | Primary |
Addresses
Primary practice location
1700 Park St
Suite #200
Alameda, CA 94501-1571
Mailing address
2440 Dana St
Berkeley, CA 94704-2266
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT292059 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479859200000",
"number": "1801339841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2440 DANA ST",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947042266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 PARK ST",
"address_2": "SUITE #200",
"city": "ALAMEDA",
"state": "CA",
"postal_code": "945011571",
"telephone_number": "510-521-5900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "HERNAN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-11-23",
"last_updated": "2016-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT292059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alameda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.