Individual provider Active NPI

Yoon Hoon Kim, MD

  • Psychiatry Physician
  • Corona, CA
National Provider Identifier
1962421529
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
C51675 Issued in CA
Practice address
629 N Main St Ste C3
Corona, CA 92880-1410
Phone
(951) 738-2400
Fax
(951) 340-3566
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35-043662 OH
Psychiatry Physician 2084P0800X C51675 CA Primary

Addresses

Primary practice location

629 N Main St Ste C3
Corona, CA 92880-1410

Mailing address

629 N Main St Ste C3
Corona, CA 92880-1410
Phone (951) 738-2400

Other practice location 1

769 W Blaine St
suite B
Riverside, CA 92507-3970
Phone (951) 358-4705

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

LicenseStateTypeSpecialty
C51675CAMDPsychiatry Physician
35-043662OHMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1962421529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 N MAIN ST STE C3",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928801410",
            "telephone_number": "951-738-2400",
            "fax_number": "951-340-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 N MAIN ST STE C3",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928801410",
            "telephone_number": "951-738-2400",
            "fax_number": "951-340-3566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "769 W Blaine St",
            "address_2": "suite B",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925073970",
            "country_code": "US",
            "telephone_number": "951-358-4705",
            "fax_number": "951-358-4719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "YOON",
        "middle_name": "HOON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35-043662",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C51675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2018; 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.