Individual provider Active NPI

Eric Kim

  • Basic Emergency Medical Technician
  • Oakland, CA
National Provider Identifier
1902587322
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Basic Emergency Medical TechnicianTaxonomy code 146N00000X
License
E095129 Issued in CA
Practice address
333 Hegenberger Rd Ste 707
Oakland, CA 94621-1463
Phone
(925) 787-0885
NPI assigned
Jul 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X E095129 CA Primary

Addresses

Primary practice location

333 Hegenberger Rd Ste 707
Oakland, CA 94621-1463

Mailing address

4111 De Paul CT
Sacramento, CA 95821-3212
Phone (925) 787-0885

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
E095129CAMDBasic Emergency Medical Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Medical Transport Inc. CurrentSince Jul 31, 2023 Accepting new patients

Locations

333 Hegenberger Rd
Ste 707
Oakland, CA 94621
Phone (925) 787-0885

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1902587322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 DE PAUL CT",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958213212",
            "telephone_number": "925-787-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 HEGENBERGER RD STE 707",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946211463",
            "telephone_number": "925-787-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ERIC",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-27",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "CA",
            "license": "E095129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.