David Y Kim, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17440 Issued in CA

Practice address

1365 S Grand Ave
Glendora, CA 91740-5047

Phone

(626) 857-2580

NPI assigned

Jun 26, 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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: david.kim.p1@direct.lakeside.nextgenshare.com

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.

• Aisthetikos, Inc

  • Plastic Surgery Physician
  • Newport Beach, CA
  • NPI 1295965440

  CA

  Medicare reassignment
• Cep America - California

  • Emergency Medicine Physician
  • Santa Ana, CA
  • NPI 1548667843

  CA

  Medicare reassignment
• Corona Regional Emergency Medical Associates Inc

  • Emergency Medicine Physician
  • Corona, CA
  • NPI 1134629298

  CA

  Medicare reassignment
• Healthcare Partners Affiliates Medical Group

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1659312593

  CA

  Medicare reassignment
• Lakeside Medical Organization, a Medical Group Inc.

  • Internal Medicine Physician
  • West Hills, CA
  • NPI 1831426642

  CA

  Medicare reassignment
• Parker Valley Emergency Physicians Medical Group Inc

  • Emergency Medicine Physician
  • Glendale, CA
  • NPI 1467755249

  CA

  Medicare reassignment
• South Coast Emergency Medical Group

  • Emergency Medicine Physician
  • Anaheim, CA
  • NPI 1831294594

  CA

  Medicare reassignment
• Cep America - California

  • Emergency Medicine Physician
  • Santa Monica, CA
  • NPI 1063081545
  NPD
• Healthcare Partners Affiliates Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Murrieta, CA
  • NPI 1760057269
  NPD
• Healthcare Partners Affiliates Medical Group

  • Addiction Medicine (Internal Medicine) Physician
  • Tustin, CA
  • NPI 1891981502
  NPD
• Centinela Freeman Emergency Medical Associates

  • Emergency Medicine Physician
  • Inglewood, CA
  • NPI 1962539684
  NPD (past)
• Grapevine Emergency Physicians Medical Group Inc

  • Emergency Medicine Physician
  • Santa Ana, CA
  • NPI 1982907770
  NPD (past)

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1922035948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405047",
            "telephone_number": "626-857-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917405047",
            "telephone_number": "626-857-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "DAVID",
        "middle_name": "Y",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayesha Khan Hawkins, M.S.P.T.
• Naveed Abas Khan, MD
• Nida Kichkla, NP
• Kathleen Kiely, RPH
• Christopher Kim
• Grace Kim, PH.D.
• Grace Mijin Kim, DDS
• Myong-Su Jeffrey Kim
• Sang Woo Kim
• Kimberlee Mendoza Marriage and Family Therapy

• All providers in Glendora, CA
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.