MR. KYOUNG JIN KIM (NPI# 1588775191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588775191 |
| Entity Type | Individual |
| Full Name | MR. KYOUNG JIN KIM |
| Credential | MD. |
| Practice Address |
4212 N 16th St Phoenix AZ 85016-5319 |
| Mailing Address |
Po Box 31001-0698 Pasadena CA 91110-0698 |
| Practice Telephone | 6022631511 |
| Practice Fax Number | 6022631637 |
| Mailing Telephone | 6022631511 |
| Mailing Fax Number | 6022361637 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | BCBS | AZ0770560 | 01 |
| AZ | 759409 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700135480 | Kyoung Hwan Kim | Acupuncturist | 7901 Greentree Rd, Bethesda, MD 20817-1301 | 2012-09-10 |
| 1801971478 | Kyoung Chol Kim | Surgery | 2970 W Olympic Blvd, Suite 204 & 205, Los Angeles, CA 90006-2518 | 2006-10-25 |
| 1699864959 | Kyoung S Kim | Internal Medicine | 169 North Plank Road, Newburgh, NY 12550 | 2006-10-12 |
| 1477882215 | Kyoung Ae Kim | Internal Medicine | 1211 W La Palma Ave, Suite 207, Anaheim, CA 92801-2815 | 2009-12-07 |
| Street Address |
4212 N 16TH ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85016-5319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184627648 | Judy Marie Pinsonneault | Family Medicine | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2005-05-27 |
| 1568071348 | Christopher Tran | Pharmacist | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2020-07-28 |
| 1659980480 | Corinne Easterling | Pharmacist | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2020-07-28 |
| 1598383192 | Tamika Howard | Pharmacist | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2020-07-09 |
| 1659901544 | Joseph Maloy | Pharmacist | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2020-01-20 |
| 1437709680 | Kymberly Sue Ludwig | Pharmacist | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2019-09-18 |
| 1962052746 | Jamie C Wilson | Registered Nurse | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2019-09-13 |
| 1427602721 | Jonathon Andrew Marquez | Respiratory Therapist, Certified | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2019-07-25 |
| 1700441664 | Douglas Edward Henry | Physical Therapist | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2019-05-07 |
| 1982189205 | Rachael Renina Hunter Edwards | Psychologist | 4212 N 16th St, Phoenix, AZ 85016-5319 | 2018-10-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992705 | Heatheranne Baker-oldfield | Counselor | 2415 E Camelback Rd Ste 700, Phoenix, AZ 85016 | 2020-11-06 |
| 1780215681 | Sip Home Systems - Mesa LLC | Home Health | 24th At Camelback, 2375 E. Camelback Rd., Suite 600, Phoenix, AZ 85016 | 2020-01-29 |
| 1760945588 | Wei Wei | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital 1919 E. Thomas Rd., Phoenix, AZ 85016 | 2019-04-09 |
| 1942765623 | Grace Hatfield | Dietitian, Registered | Phoenix Childrens Hospital 1919 E Thomas Rd, Phoenix, AZ 85016 | 2019-02-06 |
| 1861977027 | Dawn Yvette Lima | Occupational Therapy Assistant | 3128 E Cheery Ln, Phoenix, AZ 85016 | 2018-10-03 |
| 1720583685 | Kristin Pauline Hicklin | Registered Nurse | 2930 E Camelback Rd Ste 100, Phoenix, AZ 85016 | 2018-03-24 |
| 1588181622 | Taness Eyre Billington | Pharmacist | 1625 E. Camelback Rd., Phoenix, AZ 85016 | 2017-08-29 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1609396985 | Mohammed Waseemuddin | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ 85016 | 2017-06-27 |
| 1144777632 | Amanda Mazerall | Occupational Therapist | 4333 N 24th Street, Apartment 223, Phoenix, AZ 85016 | 2016-09-01 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477050375 | Blue Ye Maya LLC | Obstetrics & Gynecology | 531 E Lynwood St Fl 2, Phoenix, AZ 85004-1626 | 2018-04-09 |
| 1659717924 | Kate E Maroney | Obstetrics & Gynecology | 1661 E Camelback Rd Ste 160, Phoenix, AZ 85016-3921 | 2013-05-14 |
| 1306281571 | Jeffrey Blake Higley | Obstetrics & Gynecology | 650 W Maryland Ave Ste 1, Phoenix, AZ 85013 | 2013-05-01 |
| 1033485511 | Sigrid Gardner Williams | Obstetrics & Gynecology | 4751 N 15th St, Phoenix, AZ 85014-3707 | 2012-03-28 |
| 1316263585 | Allison Amber Snyder | Obstetrics & Gynecology | 3811 E Bell Rd Ste 312, Phoenix, AZ 85032-2160 | 2010-04-13 |
| 1033348487 | Jill D Gibson | Obstetrics & Gynecology | 1313 E Osborn Rd Ste 250, Phoenix, AZ 85014-5699 | 2009-07-07 |
| 1083841969 | Laura T Mercer | Obstetrics & Gynecology | 500 W Thomas Rd Ste 720730, Phoenix, AZ 85013-4224 | 2009-06-17 |
| 1770710097 | Adriana Lea Pritchard | Obstetrics & Gynecology | 1300 North 12th Street, Suite 407, Phoenix, AZ 85006 | 2009-06-12 |
| 1033392113 | Chijioke Nnenna Soribe | Obstetrics & Gynecology | 3003 N Central Ave Ste 1600, Phoenix, AZ 85012-2908 | 2007-12-11 |
| 1013190420 | Neil Trachtenberg, M.d.,p.c. | Obstetrics & Gynecology | 300 W Clarendon Ave Ste 145, Phoenix, AZ 85013-3449 | 2007-12-07 |
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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.