Kim Enomoto, M.D., M.P.H.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G45177 Issued in CA

Practice address

5205 Melrose Ave
Los Angeles, CA 90038-3144

Phone

(323) 653-8622

NPI assigned

Feb 12, 2007

Last updated

Jan 9, 2010By the provider in NPPES

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

Other names 1

• Kim Enomoto Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262995200000",
    "number": "1861534455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 MELROSE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900383144",
            "telephone_number": "323-653-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 MELROSE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900383144",
            "telephone_number": "323-653-8622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENOMOTO",
        "first_name": "KIM",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2010-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G45177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "ENOMOTO",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Andrea Marcia Ennis, RN, NP
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• Lindsay Enright

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2010; 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.