Ji Soo Kim, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1700 E Cesar E Chavez Ave Ste 2500
Los Angeles, CA 90033-2434

Phone

(323) 268-6731

NPI assigned

Jun 5, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Geoffrey Trenkle DO a Professional Medical Corporation

  • Otolaryngology Physician
  • Los Angeles, CA
  • NPI 1992124978
  Medicare reassignment
• Citrus Valley Medical Associates, Inc.

  • Family Medicine Physician
  • Norco, CA
  • NPI 1306033709
  NPD (past)
• Employee Medical Consultants PC

  • Medical Specialty Clinic/Center
  • Los Angeles, CA
  • NPI 1558099325
  NPD (past)
• Michael R. Gatto MD, Inc.

  • Otolaryngology Physician
  • Palm Springs, CA
  • NPI 1811991847
  NPD (past)
• Samir a Shah MD Professional Corporation

  • Ophthalmology Physician
  • Huntington Beach, CA
  • NPI 1700197365
  NPD (past)

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1801580816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E CESAR E CHAVEZ AVE STE 2500",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332434",
            "telephone_number": "323-268-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E CESAR E CHAVEZ AVE STE 2500",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332434",
            "telephone_number": "323-268-6731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JI SOO",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ji Ae Janice Kim, FNP-BC
• Ji Ah Kim, CRNA
• Ji Eun Kim, PA-C
• Ji Hye Kim
• Ji Hye Kim
• Ji Sun Kim, ACUPUNCTURIST
• Ji Yeon Kim, PHARM.D
• Ji-Hyun Kim
• Jiah Kim
• Jieun Kim

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.

Verify at the official NPI Registry.