Peter Simon Kim, DPM, MS

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E4672 Issued in CA

Practice address

5220 Pacific Concourse Dr
Ste 120
Los Angeles, CA 90045-6244

Phone

(310) 228-0396

Fax

(888) 492-2900

NPI assigned

Jun 6, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• California Foot and Ankle Institute, a Podiatry Corporation

  • Podiatrist
  • Newport Beach, CA
  • NPI 1447306964
  NPD (past)
• Fulbright Dental Group, PC

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1336384619
  NPD (past)
• Lumina Healthcare, LLC

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1932343589
  NPD (past)
• Michael D. Kotzen, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Valley Village, CA
  • NPI 1013105972
  NPD (past)

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1821257528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3156",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905103156",
            "telephone_number": "310-228-0396",
            "fax_number": "310-530-1595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 PACIFIC CONCOURSE DR",
            "address_2": "STE 120",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900456244",
            "telephone_number": "310-228-0396",
            "fax_number": "888-492-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "PETER",
        "middle_name": "SIMON",
        "name_prefix": "Dr.",
        "credential": "DPM, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "E4672",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter Kim
• Peter Kim, DDS
• Peter Kim, MD
• Peter Kim
• Peter J Kim, MD
• Phillip Jung-Wan Kim, D.C.
• Rachel Jungyun Kim, DO
• Rachel Seunah Kim, MD
• Reuben Han-Kyu Kim, DDS
• Richard B Kim, MD

• Foot & Ankle Surgery Podiatrist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.