Kyoung Chol Kim, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

A84328 Issued in CA

Practice address

2970 W Olympic Blvd
Suite 204 & 205
Los Angeles, CA 90006-2518

Phone

(213) 382-4900

Fax

(213) 382-4909

NPI assigned

Oct 25, 2006

Last updated

Sep 9, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• K. Charles Kim Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• CK Plastic Surgery Inc

  • Ambulatory Surgical Clinic/Center
  • Los Angeles, CA
  • NPI 1215392055
  NPD (past) Authorized official

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1801971478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2970 W OLYMPIC BLVD",
            "address_2": "SUITE 204 & 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062518",
            "telephone_number": "213-382-4900",
            "fax_number": "213-382-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 W OLYMPIC BLVD",
            "address_2": "SUITE 204 & 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062518",
            "telephone_number": "213-382-4900",
            "fax_number": "213-382-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "KYOUNG",
        "middle_name": "CHOL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A84328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "K.",
            "last_name": "KIM",
            "middle_name": "CHARLES",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kwang Hun Kim, ACUPUNCTURIST
• Kwangsoon Kim, L. AC.
• Kyo Sung Kim, DDS, MS
• Kyong Tai Kim, PEER EMPL SPECIALIST
• Kyoung Ae Kim, MD
• Kyoungjun Kim, PH.D.
• Kyu Min Kim
• Kyung Ae Kim, L.AC
• Kyung Ha Kim
• Kyung Hee Kim, MFT

• Plastic and Reconstructive Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Plastic and Reconstructive Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.

Verify at the official NPI Registry.