DR. PAUL KIM (NPI# 1649480393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649480393 |
| Entity Type | Individual |
| Full Name | DR. PAUL KIM |
| Credential | M.D. |
| Practice Address |
747 52nd St Oakland CA 94609-1809 |
| Practice Telephone | 5104283885 |
| Practice Fax Number | 5104505885 |
| Mailing Telephone | 5104283885 |
| Mailing Fax Number | 5104505885 |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2016-04-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
A104047 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427529973 | Paul Kim | Registered Nurse | 17314 Vickie Ave, Cerritos, CA 90703-1354 | 2018-12-10 |
| 1538600119 | Paul Kim | Physical Therapy Assistant | 1378 Willow Oak Rd, Castle Rock, CO 80104-8566 | 2017-03-15 |
| 1619417490 | Paul Kim | Pharmacist | 765 Limekiln Pike Unit 26, Glenside, PA 19038-3930 | 2017-02-28 |
| 1568919686 | Paul Kim | Dentist | Hq, 618th Dental Company (as), Usa, Health Dental Activity-korea, Seoul, APO AP 96205-5652 | 2016-09-07 |
| 1467825786 | Paul J Kim | Dentist | Ucsf Department of Surgery 513 Parnassus Ave, S321, San Francisco, CA 94143 | 2015-11-09 |
| 1336560234 | Paul Kim | Dentist | 809 N Houk Rd, Delaware, OH 43015-4418 | 2013-12-18 |
| 1841633138 | Paul Taehoon Kim | Student in an Organized Health Care Education/Training Program | 231 Albert Sabin Way Ml 0558, Univ of Cincinnati Medical Center Department of Surgery, Cincinnati, OH 45267-0588 | 2013-04-17 |
| 1174806525 | Paul Joon Kim | Dentist | 514 Fulton Ave, Hempstead, NY 11550-4364 | 2011-09-22 |
| 1275822777 | Paul Moonwhan Kim | Psychiatry & Neurology | Meyer 1-104, 600 N. Wolfe St., Baltimore, MD 21287-0001 | 2011-04-05 |
| 1477885960 | Paul Kim | Dentist | 6090 Redwood Blvd, Suite D, Novato, CA 94945-4569 | 2010-02-08 |
| Street Address |
747 52ND ST |
| City | OAKLAND |
| State | CA |
| Zip Code | 94609-1809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942200928 | James Philip Riddel Jr. | Nurse Practitioner | 747 52nd St, Oakland, CA 94609-1809 | 2005-07-29 |
| 1235739905 | Maria Elena Alicia Valdivia Fortuna | Social Worker | 747 52nd St, Oakland, CA 94609-1809 | 2020-10-30 |
| 1295342707 | Jenny Chen | Dietitian, Registered | 747 52nd St, Oakland, CA 94609-1809 | 2020-09-29 |
| 1104433028 | Phuong T Nguyen-tran | Pharmacist | 747 52nd St, Oakland, CA 94609-1809 | 2020-09-24 |
| 1114538899 | Ji Yun Lee | Student in an Organized Health Care Education/Training Program | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-14 |
| 1780295857 | Luis Alonso Perez Jr. | Social Worker | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-12 |
| 1255941803 | Aleesia Renta-ramirez | Student in an Organized Health Care Education/Training Program | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-07 |
| 1831709773 | Carroll Taylor Brown IIi | Registered Nurse | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-05 |
| 1053921064 | Jessica Stankiewicz Lightcap | Registered Nurse | 747 52nd St, Oakland, CA 94609-1809 | 2020-08-04 |
| 1184242307 | Cecilia Fairley | Genetic Counselor, MS | 747 52nd St, Oakland, CA 94609-1809 | 2020-07-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104457159 | Gerard John-charles Coughlin | Student in an Organized Health Care Education/Training Program | Samuel Merritt University, 3100 Telegraph Avenue, Oakland, CA 94609 | 2020-01-29 |
| 1417502022 | Michael Knittel | Registered Nurse | 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1962057562 | Nicole Kjolby | Registered Nurse | Samuel Merritt College, 370 Hawthorne Ave, Oakland, CA 94609 | 2019-08-09 |
| 1396208286 | Graham Vallis | Student in an Organized Health Care Education/Training Program | Ucsf Benioff Children's Hospital Oakland, 747 52nd Street, Oakland, CA 94609 | 2019-04-09 |
| 1386129526 | Gary Mitchell Snider | Counselor | 390 40th Street, Oakland, CA 94609 | 2018-10-02 |
| 1720568389 | Lice Control Inc. | Technician | 6557 Shattuck Ave, Oakland, CA 94609 | 2018-08-14 |
| 1528559150 | Jenna Marie Kincaid | Behavior Technician | 400 29th St., 204, Oakland, CA 94609 | 2018-05-18 |
| 1336656669 | Nicholas Dicarlo | Social Worker | 465 34th St Ste 6, Oakland, CA 94609 | 2018-01-09 |
| 1174045744 | Theodora J Marzouk | Home Health Aide | 3317 Elm Street, Suite 202, Oakland, CA 94609 | 2017-07-14 |
| 1740728922 | Elena Gardella | Marriage & Family Therapist | 411 30th Street, Suite 412, Oakland, CA 94609 | 2017-02-07 |
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| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154519072 | Eloa S. Adams | Pediatrics | 275 W Macarthu, Oakland, CA 94611-5641 | 2007-10-04 |
| 1164412433 | Thomas Durand Reed | Pediatrics | 747 52nd Street, Children's Hospital - Oakland, Oakland, CA 94609-0000 | 2005-10-26 |
| 1760703482 | Brendan Lawrence Gallagher | Pediatrics | 747 52nd St, Oakland, CA 94609-1809 | 2010-06-16 |
| 1063549897 | Craniofacial Med Assoc Cho | Pediatrics | 747 52nd St, Oakland, CA 94609-1809 | 2007-02-28 |
| 1871628214 | Ambulatory Med. Assoc Cho | Pediatrics | 747 52nd St, Oakland, CA 94609-1809 | 2007-02-23 |
| 1386722189 | Yvonne Rutherford | Pediatrics | 280 W Macarthur Blvd, Oakland, CA 94611-5642 | 2006-11-01 |
| 1881797157 | Children's Critical Care Medical Group, Inc. | Pediatrics | 747 52nd Street, Oakland, CA 94609 | 2006-09-05 |
| 1215974423 | Ramadevi B. Pullela | Pediatrics | 275 W Macarthur, Oakland, CA 94611-5641 | 2006-05-31 |
| 1336119510 | Sharon Williams | Pediatrics | 747 52nd St, Children's Hosp and Research Ctr. At Oak., Picu, Oakland, CA 94609-1809 | 2006-01-23 |
| 1659351054 | Vivienne Newman | Pediatrics | 747 52nd St, Oakland, CA 94609-1809 | 2006-01-20 |
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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.