Chang S. Kim, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

A34156 Issued in CA

Practice address

1310 Las Tablas Rd
Suite 103
Templeton, CA 93465-9737

Phone

(805) 461-7080

Fax

(805) 464-0243

NPI assigned

Feb 16, 2006

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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 and National Provider Directory roles.

• California Managed Imaging Medical Group, Inc

  • Vascular & Interventional Radiology Physician
  • Santa Barbara, CA
  • NPI 1821271727

  Diagnostic Radiology

  NPD (past)
• Pueblo Radiology Medical Group Inc

  • Diagnostic Radiology Physician
  • Santa Barbara, CA
  • NPI 1871549899
  NPD (past)

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1871567727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2920",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934232920",
            "telephone_number": "805-461-7080",
            "fax_number": "805-464-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 LAS TABLAS RD",
            "address_2": "SUITE 103",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659737",
            "telephone_number": "805-461-7080",
            "fax_number": "805-464-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CHANG",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A34156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A341560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Marie Kelly, PA
• Libby A Kerr, RN BSN CDE
• Meg Ketchum, NP
• Kevin Forsythe MD Inc
• Kidney Dialysis Center of Templeton,LLC
• Kinetix PT, Inc.
• Jennifer L King, PA-C
• Loren Bruce Kirk, D.D.S.
• Elvera Klein
• Brian A. Koch, MD

• Diagnostic Radiology Physician in Templeton, CA
• Providers in Templeton, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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.