Cerritos Medical Center, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G66684 Issued in CA

Legal business name

CERRITOS MEDICAL CENTER, INC

Practice address

11911 Artesia Blvd
Ste 101
Cerritos, CA 90701-4065

Phone

(562) 402-7622

Fax

(562) 402-2452

NPI assigned

Apr 23, 2008

Organization subpart

No

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

Authorized official

Name

Dr. John Shin Kim, M.D.NPI 1003991159

Title

Owner

Phone

(562) 402-7622

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• John Shin Kim, M.D.

  • Family Medicine Physician
  • Cerritos, CA
  • NPI 1003991159
  Medicare reassignment NPD Authorized official
• Teresa Jiwon Kim, NP

  • Family Nurse Practitioner
  • Cerritos, CA
  • NPI 1386078327
  Medicare reassignment NPD

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1871768663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11911 ARTESIA BLVD",
            "address_2": "STE 101",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907014065",
            "telephone_number": "562-402-7622",
            "fax_number": "562-402-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 ARTESIA BLVD",
            "address_2": "STE 101",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907014065",
            "telephone_number": "562-402-7622",
            "fax_number": "562-402-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CERRITOS MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "SHIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-402-7622",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G66684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cerritos Dialysis Center LLC
• Cerritos Endoscopic Medical Center, Inc.
• Cerritos Eye Medical Center, Inc.
• Cerritos Family Denal Center
• Cerritos Home Care Inc
• Cerritos Physical Therapy & Rehabilitation, Inc.
• Cerritos Residence Care Inc.
• Cerritos Residence Care Inc.
• Cerritos Surgery Center, LLC
• Cerritos Surgery Center, LLC

• Family Medicine Physician in Cerritos, CA
• Providers in Cerritos, 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 Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.