NPIMap

Organization Active NPI

Form Health Associates, P.C.

  • Endocrinology, Diabetes & Metabolism Physician
  • Bakersfield, CA
National Provider Identifier
1801615752
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
FORM HEALTH ASSOCIATES, P.C.
Practice address
4900 California Ave
Tower B, 2ND Floor
Bakersfield, CA 93309-7024
Phone
(617) 505-1520
Fax
(617) 928-8401
NPI assigned
Oct 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Authorized official

Name
Nam Ho Kim, MD
Title
President
Phone
(617) 505-1520

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

4900 California Ave
Tower B, 2ND Floor
Bakersfield, CA 93309-7024

Mailing address

109 State St
5TH FL
Boston, MA 02109-2906
Phone (617) 505-1520

National Provider Directory

National Provider Directory

Locations

4900 California Ave
Fl 2B
Bakersfield, CA 93309

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773792000000",
    "number": "1801615752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 STATE ST",
            "address_2": "5TH FL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021092906",
            "telephone_number": "617-505-1520",
            "fax_number": "617-928-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 CALIFORNIA AVE",
            "address_2": "TOWER B, 2ND FLOOR",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933097024",
            "telephone_number": "617-505-1520",
            "fax_number": "617-928-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORM HEALTH ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-08",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "NAM",
        "authorized_official_middle_name": "HO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-505-1520",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.