Active NPI
Thomas Kim, DO
- Family Medicine Physician
- Santa Ana, CA
National Provider Identifier
1801418041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- -
- Practice address
- 3601 W Sunflower Ave Ste 100
Santa Ana, CA 92704-7916 - Phone
- (714) 338-1115
- NPI assigned
- May 11, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | - | CT | Primary |
Addresses
Primary practice location
3601 W Sunflower Ave Ste 100
Santa Ana, CA 92704-7916
Mailing address
1037 Fedora St Unit 402
Los Angeles, CA 90006-2886
Phone (310) 347-8708
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230911001908 | MD | Order and Referring Only - Family Practice | 2163886029 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| - | CT | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723680000000",
"number": "1801418041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1037 FEDORA ST UNIT 402",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900062886",
"telephone_number": "310-347-8708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 W SUNFLOWER AVE STE 100",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927047916",
"telephone_number": "714-338-1115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "THOMAS",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-05-11",
"last_updated": "2024-08-15",
"certification_date": "2024-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CT",
"license": "-",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.