CHARLES CHOL BAE KIM (NPI# 1225564818) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225564818 |
| Entity Type | Individual |
| Full Name | CHARLES CHOL BAE KIM |
| Credential | MD |
| Practice Address |
14642 Newport Ave Ste 105 Tustin CA 92780-6058 |
| Practice Telephone | 7148311112 |
| Practice Fax Number | 7144862309 |
| Mailing Telephone | 7148311112 |
| Mailing Fax Number | 7144862309 |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2020-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
C129160 | CA | Allopathic & Osteopathic Physicians |
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
C-129160 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
14642 NEWPORT AVE STE 105 |
| City | TUSTIN |
| State | CA |
| Zip Code | 92780-6058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1063050193 | Charles Kim Md Inc | Family Medicine | 14642 Newport Ave Ste 105, Tustin, CA 92780-6058 | 2019-12-19 |
| 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 | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952631368 | Howard Brian Herdeg | Family Medicine | 13368 Savanna, Tustin, CA 92782-9143 | 2010-01-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306446091 | Candace Maglinao | Family Medicine | 21010 Anza Ave Apt 12, Torrance, CA 90503-4254 | 2020-10-30 |
| 1942826797 | In-home Medical Mobile Services, Inc. | Family Medicine | 3400 E 8th St Ste 202, National City, CA 91950-3169 | 2020-06-17 |
| 1386269306 | Universal Mobile Doctors Inc | Family Medicine | 15333 Sherman Way Ste P, Van Nuys, CA 91406-4204 | 2020-06-16 |
| 1619597671 | Harry Eisenbach | Family Medicine | 9312 Smoketree Ln, Villa Park, CA 92861-1011 | 2020-04-20 |
| 1669092854 | Wellbeing Clinic Inc | Family Medicine | 1621 S New Hampshire Ave, Los Angeles, CA 90006-4513 | 2020-04-17 |
| 1619513611 | Krista Mckinney | Family Medicine | 344o E. La Palma Avenue, Anaheim, CA 92806 | 2019-11-25 |
| 1457995565 | Ucsf Medical Group Business Services | Family Medicine | 1100 Park Pl Ste 100, San Mateo, CA 94403-7119 | 2019-10-31 |
| 1780237313 | Charles Kim Md Inc | Family Medicine | 3055 W Orange Ave Ste 204, Anaheim, CA 92804-3154 | 2019-07-23 |
| 1083277206 | Baum 5 Star Healthcare | Family Medicine | 560 W Grangeville Blvd Ste A, Hanford, CA 93230-2858 | 2019-04-15 |
| 1477025278 | Connexus Family Clinic Inc | Family Medicine | 1930 E. Anaheim Street, N/a, Long Beach, CA 90813-3908 | 2018-12-19 |
| 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.