Richard Seongjun Kim, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A69774 Issued in CA

Practice address

28647 S. Western Ave.
Rancho Palos Verdes, CA 90275

Phone

(310) 882-0873

Fax

(310) 881-1188

NPI assigned

Mar 22, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1992764344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28647 S. WESTERN AVE.",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "90275",
            "telephone_number": "310-882-0873",
            "fax_number": "310-881-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28647 S. WESTERN AVE.",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "90275",
            "telephone_number": "310-882-0873",
            "fax_number": "310-881-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "RICHARD",
        "middle_name": "SEONGJUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A69774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A69774",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlene Nomura Kim
• Christopher Martin Kim, VN 271530
• Daniel Kim
• Evan Hyunwu Kim, DDS
• Minseag Kim
• Mary Nell Kocman
• Harini Delia Koko, AGNP-C
• Glen Isamu Komatsu, M.D.
• Nicola Akiko Koyama, P.T.
• Donna Marie Krogh, PHD

• Internal Medicine Physician in Rancho Palos Verdes, CA
• Providers in Rancho Palos Verdes, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.