Active NPI
Tim Inchul Kim, M.D.
- Neuro-ophthalmology Physician
- San Diego, CA
National Provider Identifier
1932306925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuro-ophthalmology Physician
- License
- 24800
- Practice address
- 34800 Bob Wilson Dr
San Diego, CA 92134-1098 - Phone
- (619) 532-6400
- NPI assigned
- Jul 2, 2007
- Last updated
- Oct 20, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuro-ophthalmology Physician | 207WX0109X | 24800 | NE | Primary |
Addresses
Primary practice location
34800 Bob Wilson Dr
San Diego, CA 92134-1098
Mailing address
1817 Sebastopol St
Chula Vista, CA 91913-1634
Phone (913) 219-9409
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220927000743 | NE | Order and Referring Only - Ophthalmology | 2264673334 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24800 | NE | MD | Neuro-ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neuro-Ophthalmologic Associates PC | Past | Accepting new patients | |
| Weoc ER Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Ophthalmology Physician
- Philadelphia, PA
- NPI 1093714420
-
- Ophthalmology Physician
- Philadelphia, PA
- NPI 1194953760
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666224000000",
"number": "1932306925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1817 SEBASTOPOL ST",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919131634",
"telephone_number": "913-219-9409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34800 BOB WILSON DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921341098",
"telephone_number": "619-532-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "TIM",
"middle_name": "INCHUL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-02",
"last_updated": "2022-10-20",
"certification_date": "2022-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "207WX0109X",
"taxonomy_group": "",
"desc": "Ophthalmology, Neuro-ophthalmology",
"state": "NE",
"license": "24800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.