Active NPI
Gene Young Kim, M.D.
- Diagnostic Radiology Physician
- Stanford, CA
National Provider Identifier
1891172169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- A172512
- Practice address
- 300 Pasteur Dr
Stanford, CA 94305-2200 - Phone
- (650) 723-4000
- NPI assigned
- May 6, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Diagnostic Radiology Physician | 2085R0202X | A172512 | CA | Primary |
| Diagnostic Radiology Physician | 2085R0202X | 268809 | MA |
Addresses
Primary practice location
300 Pasteur Dr
Stanford, CA 94305-2200
Mailing address
300 Pasteur Dr
Stanford, CA 94305-2200
Other practice location 1
2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-4175
Other practice location 2
820 Harrison Ave Bldg 3
Boston, MA 02118-2905
Phone (617) 414-5135
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A172512 | CA | MD | Diagnostic Radiology Physician |
| 268809 | MA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644278400000",
"number": "1891172169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 PASTEUR DR",
"city": "STANFORD",
"state": "CA",
"postal_code": "943052200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PASTEUR DR",
"city": "STANFORD",
"state": "CA",
"postal_code": "943052200",
"telephone_number": "650-723-4000"
}
],
"practiceLocations": [
{
"address_1": "2301 Holmes St",
"address_purpose": "LOCATION",
"city": "Kansas City",
"state": "MO",
"postal_code": "641082640",
"country_code": "US",
"telephone_number": "816-404-4175",
"fax_number": "816-404-0003",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "820 Harrison Ave Bldg 3",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021182905",
"country_code": "US",
"telephone_number": "617-414-5135",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "GENE",
"middle_name": "YOUNG",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-06",
"last_updated": "2022-02-08",
"certification_date": "2022-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "A172512",
"primary": true
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "268809",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stanford, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.