JAE J. KIM, M.D. (NPI# 1073796843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073796843 |
| Entity Type | Organization |
| Organization Name | JAE J. KIM, M.D. |
| Other Organization Name | SHAFTER RURAL HEALTH CARE CLINIC |
| Practice Address |
565 Kern St Shafter CA 93263-2133 |
| Practice Telephone | 6617464937 |
| Mailing Telephone | 6617464937 |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2008-06-27 |
| Authorized Official Name | VICKIE WILLIAMSON (OFFICE SUPERVISOR) |
| Authorized Official Telephone | 6617464937 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
A38875 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RHM53819F | 05 |
| Other Name | Type Code |
|---|---|
| Shafter Rural Health Care Clinic | Doing Business As Name - Organization |
| Street Address |
565 KERN ST |
| City | SHAFTER |
| State | CA |
| Zip Code | 93263-2133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841264918 | Jae Joon Kim | Family Medicine | 565 Kern St, Shafter, CA 93263-2133 | 2006-02-15 |
| 1902364151 | Kimberly Gonzalez | Nurse Practitioner | 565 Kern St, Shafter, CA 93263-2133 | 2019-03-06 |
| 1609281310 | Vanguard Medical Corporation | Clinic/Center | 565 Kern St, Shafter, CA 93263-2133 | 2014-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265958235 | Danessa Thorbrogger | Nurse Practitioner | 565 Kern Street, Shafter, CA 93263 | 2017-08-21 |
| 1376994533 | Shafter Urgent Care | Clinic/Center | 501 Munzer St Ste A, Shafter, CA 93263 | 2016-06-28 |
| 1821442658 | Huy Xuan Dang | Pharmacist | 825 Central Valley Hwy Ste A, Shafter, CA 93263 | 2016-04-18 |
| 1811362908 | Shafter Pediatrics | Pediatrics | 501 Munzer St, Suite C, Shafter, CA 93263 | 2015-12-01 |
| 1174769616 | Parrott Gordon & Associates L.p. | Dentist | 1110 E. Lerdo Highway, 200, Shafter, CA 93263 | 2009-01-06 |
| 1164696449 | Michael Komin Md Medical Corportion | Preferred Provider Organization | 1150 E Lerdo Hwy #c, Shafter, CA 93263 | 2008-04-17 |
| 1154526176 | Christine M Armstrong | Counselor | 151 Munzes St, Shefter, CA 93263 | 2007-06-19 |
| 1336327154 | Omni Family Health | Clinical Medical Laboratory | 659 S Central Valley Hwy, Shafter, CA 93263 | 2008-02-04 |
| 1477677821 | Joel N Cooper Physical Therapist Inc. | Physical Therapist | 142 E Tulare Ave, Shafter, CA 93263-1834 | 2007-03-19 |
| 1023060571 | Ggnsc Shafter Lp | Skilled Nursing Facility | 140 E Tulare Ave, Shafter, CA 93263-1834 | 2006-05-16 |
| Find all providers in zip 93263 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
| 1821699521 | Flora Lim | Clinic/Center | 2500 Alton Pkwy Ste 108, Irvine, CA 92606-5032 | 2020-11-08 |
| 1902405715 | Riverside Primary Care Clinic, Joanna Ayala Md | Clinic/Center | 3978 Merrill Ave, Riverside, CA 92506 | 2020-10-22 |
| 1275131765 | Uzoma Uwakah | Clinic/Center | 2521 Seminary Ave # 1, Oakland, CA 94605-1307 | 2020-10-15 |
| 1508464470 | Pestle Health LLC | Clinic/Center | 550 Gene Friend Way Apt 214, San Francisco, CA 94158-2283 | 2020-10-13 |
| 1902404247 | Arbol Acupuncture | Clinic/Center | 2620 Foothill Blvd Ste A, La Crescenta, CA 91214-4509 | 2020-10-09 |
| 1346857802 | Sos Environmental Health | Clinic/Center | 59 Estaban Dr, Camarillo, CA 93010-1609 | 2020-09-29 |
| 1457966442 | Carlos A. Alvarez., Md., Inc | Clinic/Center | 6001 Truxtun Ave Ste 220, Bakersfield, CA 93309-0662 | 2020-09-15 |
| 1265046395 | Riverway Medical Group A Medical Corporation | Clinic/Center | 1827 S Court St Ste B, Visalia, CA 93277-5469 | 2020-09-05 |
| 1386258754 | Apollo Health Services Inc | Clinic/Center | 438 E Katella Ave Ste 229, Orange, CA 92867-4803 | 2020-09-03 |
| 1538772843 | Unlimited Urgent Care Inc. | Clinic/Center | 8781 Van Nuys Blvd Ste A, Panorama City, CA 91402-2401 | 2020-08-26 |
| 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.