Kim Medical Corporation

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

KIM MEDICAL CORPORATION

Practice address

1950 Sunny Crest Dr Ste 2700
Fullerton, CA 92835-3645

Phone

(714) 519-3545

Fax

(714) 870-0000

NPI assigned

Oct 17, 2018

Organization subpart

No

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

Authorized official

Name

Jason H Kim, MD

Title

Ceo

Phone

(714) 447-4100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diana Ahn, AUD

  • Audiologist
  • Los Angeles, CA
  • NPI 1659892149

  CA

  Medicare reassignment NPD
• Jason H H Kim, MD

  • Otolaryngology Physician
  • Fullerton, CA
  • NPI 1225118979

  CA, Otolaryngology

  Medicare reassignment NPD

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552262400000",
    "number": "1972079903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 SUNNY CREST DR STE 2700",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353645",
            "telephone_number": "714-519-3545",
            "fax_number": "714-870-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 SUNNY CREST DR STE 2700",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353645",
            "telephone_number": "714-519-3545",
            "fax_number": "714-870-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-17",
        "last_updated": "2019-03-11",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-447-4100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Khzouz, D.D.S.
• Kidstrong Medical Group Inc.
• Sharon Elaine Kiel, LMFT
• Kristy Kierulff, BA
• Aynur Luna Kilic
• Mikyong Kim-Goh, PH.D., LCSW
• Alice Kisun Kim, PMHNP
• Amanda Kim
• Amber Eunah Kim, RN
• Angie Eunji Kim

• All providers in Fullerton, CA
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.

Verify at the official NPI Registry.