Jiensup Kim, M.D. Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

G75806 Issued in CA

Legal business name

JIENSUP KIM, M.D. INC.

Practice address

10431 Commerce St
Suite a
Redlands, CA 92374-2833

Phone

(909) 796-7700

Fax

(909) 796-4383

NPI assigned

Nov 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jiensup Kim, M.D.

Title

President

Phone

(909) 370-0300

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300924800000",
    "number": "1982775524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923730021",
            "telephone_number": "909-370-0300",
            "fax_number": "909-370-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10431 COMMERCE ST",
            "address_2": "SUITE A",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923742833",
            "telephone_number": "909-796-7700",
            "fax_number": "909-796-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIENSUP KIM, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2011-03-24",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "JIENSUP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-370-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G75806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1639131154",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yanghoon Peter Jeong
• Mathew Jerome
• Jessica de la Rosa Licensed Clinical Social Worker, Inc.
• Jesus a Flores D D S
• Jessica Jewett, OTR/L
• Arshad Jiffry, M.D.
• Ann Jih, LMFT
• Jill Pollock Marriage and Family Therapy
• Noah Jimenez
• Ruth Jimenez, RD

• Specialist in Redlands, CA
• Providers in Redlands, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.