PETER CHANG KIM (NPI# 1053340687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053340687 |
| Entity Type | Individual |
| Full Name | PETER CHANG KIM |
| Credential | DPM |
| Practice Address |
4482 Barranca Pkwy Ste 228 Irvine CA 92604-1738 |
| Mailing Address |
4482 Barranca Pkwy Ste 228 Irvine CA 92604-1738 |
| Practice Telephone | 9493793080 |
| Practice Fax Number | 9493793020 |
| Mailing Telephone | 9493793080 |
| Mailing Fax Number | 9493793020 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
E4027 | CA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DNERC REG O | 1316930001 | 01 |
| CA | 000E40272 | 05 | |
| CA | BLUE SHIELD | 000E40270 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 62 Corporate Park, Suite 245, Irvine, CA 926063127 | 9493793080 | 9493793020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295298891 | Peter Y Kim | Specialist | 1380 Howard St # 201c, San Francisco, CA 94103-2638 | 2019-04-10 |
| 1922518208 | Peter Kim | Dentist | 15737 E Prentice Dr, Centennial, CO 80015-4264 | 2017-10-02 |
| 1336593391 | Peter Eugene Kim | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of Radiology, Albany, NY 12208 | 2016-04-15 |
| 1821475369 | Peter Eusuk Kim | Dentist | 4649 Loma Del Sur Dr, Apt 3307, El Paso, TX 79934-3350 | 2015-05-05 |
| 1497041438 | Peter P Kim | Orthotic Fitter | 720 S. Ramona Ave., Suite 103, Corona, CA 92879-2147 | 2011-06-28 |
| 1184915761 | Peter Hwa Kim | Acupuncturist | 801 N Tustin Ave Ste 501, Santa Ana, CA 92705-3609 | 2011-04-29 |
| 1821257528 | Peter Simon Kim | Podiatrist | 5220 Pacific Concourse Dr, Ste 120, Los Angeles, CA 90045-6244 | 2008-06-06 |
| 1164603965 | Peter Yeon-seong Kim | Internal Medicine | 1400 Pressler, Suite Fct 11.5012, Md Anderson Cancer - Pickens Academic Tower, Houston, TX 77030 | 2007-11-20 |
| 1972725844 | Peter M Kim | Dentist | 2415 G St, Bakersfield, CA 93301-2809 | 2007-05-02 |
| 1053454983 | Peter Sang Kim | Acupuncturist | 929 N Western Ave, Los Angeles, CA 90029-3215 | 2007-02-14 |
| Street Address |
4482 BARRANCA PKWY STE 228 |
| City | IRVINE |
| State | CA |
| Zip Code | 92604-1738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417643 | New Skin and Body Aesthetics Inc | Internal Medicine | 4980 Barranca Parkway, 201, Irvine, CA 92604 | 2020-11-02 |
| 1679091144 | Alan Chang | Pharmacist | 5385 Alton Parkway, Irvine, CA 92604 | 2017-09-06 |
| 1942751599 | Haleh Ranjijifroody | Chiropractor | 4980 Barranca Parkway Unit 200, Irvine, CA 92604 | 2016-10-19 |
| 1265982136 | Nora M Balke | Nurse Practitioner | 4968 Booth Cir Ste 110, Irvine, CA 92604 | 2016-10-04 |
| 1679945612 | Cvs Pharmacy | Pharmacist | 15333 Culver Drive, Suite 300, Irvine, CA 92604 | 2015-10-29 |
| 1184016230 | Keri Blasingame | Nurse Practitioner | 4980 Barranca Parkway Suite 200, Irvine, CA 92604 | 2015-02-26 |
| 1679979827 | Oc Women's Health,apc | Obstetrics & Gynecology | 14252 Culver Drive Suite A 499, Irvine, CA 92604 | 2014-11-17 |
| 1326443920 | Peter Sumarsono Professional Dental Corporation | Preferred Provider Organization | 4605 Barranca Parkway., 200, Irvine, CA 92604 | 2014-10-27 |
| 1164832218 | Abdiel Noe Hernandez | Driver | 14252 Culver Drive Ste A, Irvine, CA 92604 | 2014-04-29 |
| 1811315781 | Trisha Sharma | Internal Medicine | 6 Willard St, Kaiser Permanente- Barranca Medical Office Building, Irvine, CA 92604 | 2014-03-28 |
| Find all providers in zip 92604 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760017438 | Karen Romines Podiatry Incorporated | Podiatrist | 10100 Fair Oaks Blvd Ste A, Fair Oaks, CA 95628-7154 | 2020-03-03 |
| 1033759709 | Igal Palma | Podiatrist | 2987 Grant St, Concord, CA 94520-4640 | 2020-01-10 |
| 1376013730 | Fatah Paramole Dpm LLC | Podiatrist | 561 N Alta Ave Ste A, Dinuba, CA 93618-3200 | 2018-11-28 |
| 1053893347 | Sacramento Foot and Ankle Center, Inc. | Podiatrist | 5030 J St Ste 300, Sacramento, CA 95819 | 2018-09-04 |
| 1669988655 | Happy Feet Podiatry P.C. | Podiatrist | 601 E Yorba Linda Blvd Ste 6, Placentia, CA 92870-3006 | 2017-12-28 |
| 1023549987 | Carl Christenson, Dpm | Podiatrist | 7687 N 9th St, Fresno, CA 93720-2629 | 2017-03-22 |
| 1598203788 | Bermar Group Inc | Podiatrist | 7952 Genesta Ave, Lake Balboa, CA 91406-1624 | 2017-02-07 |
| 1063871234 | Gregory W Herb | Podiatrist | 195 Blossom Hill Rd Lot 148, San Jose, CA 95123-2349 | 2016-02-17 |
| 1053791509 | Grandy Podiatry Group | Podiatrist | 730 46th St, Sacramento, CA 95819-3149 | 2015-05-30 |
| 1801201389 | Alycia Chen | Podiatrist | 305 South Dr Ste 6, Mountain View, CA 94040-4207 | 2014-06-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.