CHARLES KIM MD INC


Address: 14642 Newport Ave Ste 105, Tustin, CA 92780-6058
Phone: 9518015566

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QG0300X Family Medicine
Specialization: Geriatric Medicine
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Luzwave Medical Group Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 14642 NEWPORT AVE STE 105
City TUSTIN
State CA
Zip Code 92780-6058

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207QG0300X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Geriatric Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1073603361 Vincent D Nguyen Family Medicine 15509 Sonora St, Tustin, CA 92782-1937 2006-10-15

Providers in the same taxonomy and state

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
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Competitor

Search similar providers

City TUSTIN
Zip Code 92780

Improve Information

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Dataset Information

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.

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