CHARLES KIM MD INC (NPI# 1063050193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063050193 |
Entity Type | Organization |
Organization Name | CHARLES KIM MD INC |
Practice Address |
14642 Newport Ave Ste 105 Tustin CA 92780-6058 |
Practice Telephone | 9518015566 |
Practice Fax Number | 7144862309 |
Mailing Telephone | 9518015566 |
Mailing Fax Number | 7144862309 |
Enumeration Date | 2019-12-19 |
Last Update Date | 2019-12-19 |
Authorized Official Name | LINDA MACK (ADMINISTRATOR/DELEGATED OFFICIAL) |
Authorized Official Telephone | 9518015566 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Luzwave Medical Group | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780237313 | Charles Kim Md Inc | Family Medicine | 3055 W Orange Ave Ste 204, Anaheim, CA 92804-3154 | 2019-07-23 |
Street Address |
14642 NEWPORT AVE STE 105 |
City | TUSTIN |
State | CA |
Zip Code | 92780-6058 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225564818 | Charles Chol Bae Kim | Family Medicine | 14642 Newport Ave Ste 105, Tustin, CA 92780-6058 | 2017-05-03 |
1043810815 | Oc Holistic Care Inc. | Acupuncturist | 14642 Newport Ave Ste 105, Tustin, CA 92780-6058 | 2020-10-29 |
1174122436 | Richard Lin Do Inc | Orthopaedic Surgery | 14642 Newport Ave Ste 105, Tustin, CA 92780-6058 | 2020-10-19 |
1972139376 | H. Choi Acupuncture Inc. | Acupuncturist | 14642 Newport Ave Ste 105, Tustin, CA 92780-6058 | 2020-03-17 |
1659913291 | Solandsoul Medical Group, A Professional Medical Corporation | Clinic/Center | 14642 Newport Ave Ste 105, Tustin, CA 92780-6058 | 2019-10-15 |
1174164917 | Luzwave Art of Healing Inc. | Clinic/Center | 14642 Newport Ave Ste 105, Tustin, CA 92780-6058 | 2019-10-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437780947 | John Michael Michael | Pharmacist | 14481 Wildeve Ln, Tustin, CA 92780 | 2020-02-03 |
1609426881 | Abigail Joy Maqsood | Behavior Technician | 290a S Prospect Ave, Tustin, CA 92780 | 2019-09-19 |
1255814711 | Hyun Dong Lee | Chiropractor | 14591 Newport Ave Ste 106, Tustin, CA 92780 | 2018-09-11 |
1346733573 | Elizabeth Kim Nguyen Dds Inc | Clinic/Center | 14521 Red Hill Ave, Tustin, CA 92780 | 2018-06-12 |
1255829503 | Hw Physical Therapy | Physical Therapist | 250 El Camino Real Ste 100, Tustin, CA 92780 | 2018-04-23 |
1912494352 | Gary Wayne Mcbeath | Marriage & Family Therapist | 17821 E 17th Street, Suite # 260, Tustin, CA 92780 | 2018-04-20 |
1104334598 | Catherine Bogues | Speech-Language Pathologist | 661 West 1st Street, Suite E, Tustin, CA 92780 | 2018-01-19 |
1972019941 | Lighthouse Behavioral Solutions | Behavioral Analyst | 18002 Irvine Blvd., Suite 202c, Tustin, CA 92780 | 2017-12-28 |
1629597299 | Lifecab, LLC | Non-emergency Medical Transport (VAN) | 13732 Newport Ave, Suite #1, Tustin, CA 92780 | 2017-09-14 |
1437606555 | Tustin Speech Therapy, Inc. | Speech-Language Pathologist | 661 West First Street, Suite E, Tustin, CA 92780 | 2016-09-07 |
Find all providers in zip 92780 |
Taxonomy Code | 207QG0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Geriatric Medicine |
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073603361 | Vincent D Nguyen | Family Medicine | 15509 Sonora St, Tustin, CA 92782-1937 | 2006-10-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013516996 | Natasha Harmis | Family Medicine | 1608 Lawndale Rd, El Cajon, CA 92019-3776 | 2020-10-21 |
1073135406 | California Gerontology Clinic | Family Medicine | 1042 S Kingsley Dr Ste 3, Los Angeles, CA 90006-2408 | 2020-05-07 |
1225657331 | Samantha Lillian Escalera | Family Medicine | 9608 Planter St, Pico Rivera, CA 90660-4743 | 2020-04-09 |
1164058897 | Amani A Osman | Family Medicine | 9753 Holder St, Cypress, CA 90630-4004 | 2020-03-13 |
1396378980 | David F Shirley M D P C | Family Medicine | 4001 Impala Circle, Roseville, CA 95678 | 2020-02-21 |
1013549914 | Vertini Medical Group Inc | Family Medicine | 1001 W Carson St Ste S, Torrance, CA 90502-2051 | 2020-02-07 |
1295297463 | Cedars Family Medicine Inc | Family Medicine | 18021 Sky Park Cir Ste G, Irvine, CA 92614-6569 | 2019-04-04 |
1811455967 | Hope Geriatric Medical Center Inc | Family Medicine | 9 Coursan, Laguna Niguel, CA 92677-8902 | 2019-03-07 |
1245702174 | Jonah Medical Group Inc | Family Medicine | 20627 Golden Springs Dr Ste D, Walnut, CA 91789-4814 | 2018-12-17 |
1104392885 | Wilshire Connected Care | Family Medicine | 277 South St Ste S, San Luis Obispo, CA 93401-5039 | 2018-10-19 |
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.