NPIMap

Organization Active NPI

Magnolia Women's Center

  • Obstetrics & Gynecology Physician
  • Riverside, CA
National Provider Identifier
1912905191
Registry record updated Jul 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MAGNOLIA WOMEN'S CENTER
Practice address
3975 Jackson St
Ste 110
Riverside, CA 92503-3901
Phone
(951) 351-1071
Fax
(951) 351-1207
NPI assigned
Jul 12, 2005
Last updated
Jul 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2010

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

Authorized official

Name
Ok Suk Kim, MDNPI 1376542852
Title
Owner
Phone
(951) 351-1071

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

3975 Jackson St
Ste 110
Riverside, CA 92503-3901

Mailing address

3975 Jackson St
Ste 110
Riverside, CA 92503-3901
Phone (951) 351-1071

National Provider Directory

National Provider Directory

Locations

12712 Heacock St
Ste 9B
Moreno Valley, CA 92553
Phone (951) 242-2022

4000 14th St
Ste 401
Riverside, CA 92501
Phone (909) 788-6012

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280448000000",
    "number": "1912905191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 JACKSON ST",
            "address_2": "STE 110",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033901",
            "telephone_number": "951-351-1071",
            "fax_number": "951-351-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 JACKSON ST",
            "address_2": "STE 110",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033901",
            "telephone_number": "951-351-1071",
            "fax_number": "951-351-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA WOMEN'S CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2010-07-30",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "OK",
        "authorized_official_middle_name": "SUK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-351-1071",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.