JIENSUP KIM (NPI# 1639131154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639131154 |
| Entity Type | Individual |
| Full Name | JIENSUP KIM |
| Credential | M.D. |
| Practice Address |
900 E Washington St Suite 100a Colton CA 92324-7111 |
| Mailing Address |
Po Box 71 Redlands CA 92373-0021 |
| Practice Telephone | 9093700300 |
| Practice Fax Number | 9093700303 |
| Mailing Telephone | 9093700300 |
| Mailing Fax Number | 9093700303 |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2011-03-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
G75806 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
900 E WASHINGTON ST SUITE 100A |
| City | COLTON |
| State | CA |
| Zip Code | 92324-7111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033114764 | Premier Outpatient Surgery Center, Inc. | Clinic/Center | 900 E Washington St, Ste 155, Colton, CA 92324-4196 | 2005-06-17 |
| 1184163016 | Global Anesthesia Services Inc A Professional Nursing Corporation | Nurse Anesthetist, Certified Registered | 900 E Washington St, Suite 155, Colton, CA 92324-7111 | 2017-02-12 |
| 1740653385 | Premier Surgery Center, Inc. | Clinic/Center | 900 E Washington St, Colton, CA 92324-7111 | 2015-11-04 |
| 1598190589 | Mission Imaging Inc | Clinic/Center | 900 E Washington St, Suite 150, Colton, CA 92324-7111 | 2013-09-09 |
| 1306183835 | Jiensup Kim Md A Professional Corporation | Specialist | 900 E Washington St, Suite 100a, Colton, CA 92324-4120 | 2013-01-03 |
| 1629313739 | Colton Ca Multi Asc Lp | Clinic/Center | 900 E Washington St, Suite 155, Colton, CA 92324-7111 | 2012-11-29 |
| 1346508983 | Barry A Wood | Physical Therapist | 900 E Washington St, Ste. 100, Colton, CA 92324-7111 | 2012-05-02 |
| 1417229303 | Patrick Jerome Wymore | Chiropractor | 900 E Washington St, Suite 300, Colton, CA 92324-7111 | 2012-02-07 |
| 1568759082 | University Spine and Orthopedics | Orthopaedic Surgery | 900 E Washington St, Suite 100, Colton, CA 92324-7111 | 2011-07-05 |
| 1992000574 | Patrick Tye Creasy | Physician Assistant | 900 E Washington St, Suite 301, Colton, CA 92324-7111 | 2011-01-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739949 | Ava Vascular | Radiology | 1281 W. C. Street, Suite 200, Colton, CA 92324 | 2020-08-06 |
| 1063042851 | Making A Difference Association, Inc. | Psychologist | 1430 E Cooley Drive, Ste 111, Colton, CA 92324 | 2020-01-21 |
| 1326685488 | Allstar Medical Respite and Recuperative Care | Case Management | 450 N Sperry Drive, Colton, CA 92324 | 2019-12-06 |
| 1558916379 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1010 North Pepper Ave, Colton, CA 92324 | 2019-08-08 |
| 1326692633 | Kadi Lyn Pearce | Licensed Practical Nurse | 970 N. Latham St, Colton, CA 92324 | 2019-07-25 |
| 1184281966 | Steven Andrew Cardoza | Physician Assistant | Armc, 400 N. Pepper Ave, Colton, CA 92324 | 2019-05-28 |
| 1528540952 | Daniel Tochukwu Umah-mgborogwu | Physician Assistant | 400 N Pepper Ave, Ste 107, Coton, CA 92324 | 2018-09-01 |
| 1255826038 | Cal Med Vascular Center LLC | Clinic/Center | 1281 W C St, Colton, CA 92324 | 2018-06-25 |
| 1891288072 | A. Arroyo Lourenco Dds, Inc | Dentist | 827 W Valley Blvd., Colton, CA 92324 | 2018-06-12 |
| 1700396165 | Emily Covington | Registered Nurse | 1550 E. Washington St., Ste 101, Colton, CA 92324 | 2017-10-11 |
| Find all providers in zip 92324 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629062435 | Edward Albert Guarin Balbas | Physical Medicine & Rehabilitation | 900 E Washington St Ste 300, Colton, CA 92324-8182 | 2005-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295608 | San Diego Comprehensive Pain Management Center, Inc | Physical Medicine & Rehabilitation | 1575 W Main St, El Centro, CA 92243-2211 | 2020-11-06 |
| 1760013536 | Aveva Medical Aesthetics Inc. | Physical Medicine & Rehabilitation | 4702 W 1st St Ste C, Santa Ana, CA 92703-3100 | 2020-01-30 |
| 1902445620 | Irina L Melnik, Md Professional Corporation | Physical Medicine & Rehabilitation | 655 Redwood Hwy Frontage Rd Ste 203, Mill Valley, CA 94941-3025 | 2019-12-27 |
| 1124669544 | Algos Inc., A Medical Corporation | Physical Medicine & Rehabilitation | 26357 Mcbean Pkwy Ste 210, Santa Clarita, CA 91355-4497 | 2019-10-07 |
| 1174084578 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 802 Iowa Ave, Los Banos, CA 93635-3450 | 2019-03-28 |
| 1083175483 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 777 S Ham Ln Ste G, Lodi, CA 95242-3593 | 2019-03-28 |
| 1679031611 | Jesus H. Lao Md Inc | Physical Medicine & Rehabilitation | 6699 Alvarado Rd Ste 2304, San Diego, CA 92120-5241 | 2019-03-08 |
| 1316404262 | Advanced Pain Diagnostic & Solutions, Inc. | Physical Medicine & Rehabilitation | 1921 Sycamore Ln, Davis, CA 95616-0844 | 2019-02-27 |
| 1689157059 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 801 E Chapel St Ste 6, Santa Maria, CA 93454-4607 | 2018-09-12 |
| 1588147094 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 803 Coffee Rd Ste 11, Modesto, CA 95355-4244 | 2018-09-11 |
| 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.