DR. CHARLES CHANG HEE KIM (NPI# 1679787055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679787055 |
| Entity Type | Individual |
| Full Name | DR. CHARLES CHANG HEE KIM |
| Other Name | CHANG HEE KIM |
| Credential | M.D. |
| Practice Address |
401 Phalen Blvd Saint Paul MN 55130-5302 |
| Mailing Address |
8170 33rd Ave S Ms21110q Minneapolis MN 55425-4516 |
| Practice Telephone | 6512547500 |
| Practice Fax Number | 6512547557 |
| Mailing Telephone | 6512547500 |
| Mailing Fax Number | 6512547557 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2019-11-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 56188 | MN | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | A80043 | CA | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | 6940151-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | MD430964 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2792385 | 05 | |
| WV | 3810009247 | 05 | |
| PA | 1019196800001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427467331 | Charles Kim | Dentist | 18605 Cecelia Way, Cerritos, CA 90703-6136 | 2014-08-05 |
| 1912331141 | Charles J Kim | Dentist | 406 Sw 336th Ct, Federal Way, WA 98023-8301 | 2013-08-23 |
| 1306090246 | Charles J Kim | Dentist | 500 N Central Ave Ste 700, Glendale, CA 91203-3342 | 2008-11-05 |
| 1043420268 | Charles Kim | Optometrist | 94-07a 46 Avenue, 2nd Floor, Elmhurst, NY 11373 | 2007-05-23 |
| 1063429447 | Charles Junghyun Kim | Dentist | 10217 19th Ave Se Ste 202, Everett, WA 98208-4266 | 2006-08-01 |
| 1154361434 | Charles S. Kim | Specialist | 631 Cleveland Ave S Ste 5, Saint Paul, MN 55116-1244 | 2006-06-07 |
| 1699208074 | Charles Kim | Student in an Organized Health Care Education/Training Program | 430 Clarkson Avenue, Room Bsb 2-74, Brooklyn, NY 11203 | 2017-04-04 |
| 1740674761 | Charles C Kim | Hospitalist | 1375 E 19th Ave, Denver, CO 80218-1114 | 2015-03-27 |
| 1104242924 | Charles Kim | Ophthalmology | 1899 W March Ln, Stockton, CA 95207-6402 | 2014-03-18 |
| 1447523568 | Charles Chanwoong Kim | Dentist | 12142 Yosemite Blvd, Waterford, CA 95386-9163 | 2012-02-21 |
| Street Address |
401 PHALEN BLVD |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55130-5302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982699740 | Marlane J Brown | Optometrist | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2005-09-16 |
| 1588297113 | Choua Yang Polaski | Nurse Practitioner | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2020-02-21 |
| 1588295687 | Fadumo Adan Salad | Nurse Practitioner | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2020-01-28 |
| 1992345110 | Hannah Kristine Dahl | Physician Assistant | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2020-01-15 |
| 1417476185 | Rebecca Horvath | Audiologist | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2017-09-14 |
| 1154867430 | Erika Jarvey | Physician Assistant | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2017-01-11 |
| 1134674682 | Kacie Jo Massey | Physician Assistant | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2016-08-24 |
| 1902251325 | Jennifer Lonetti | Physical Therapist | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2016-05-04 |
| 1003270232 | Andrea Langeveld | Dermatology | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2016-04-13 |
| 1649640152 | Brittany Rae Kelly | Physician Assistant | 401 Phalen Blvd, Saint Paul, MN 55130 | 2015-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164904587 | Confident Care LLC | In Home Supportive Care | 1040 Arkwright Street, Saint Paul, MN 55130 | 2018-09-01 |
| 1881015253 | Lucas Bosco Wanga | Psychologist | 715 Edgerton Street, Merrick Community Services, St. Paul, MN 55130 | 2014-01-02 |
| 1174865570 | Sarang Patel | Internal Medicine | 401 Phalen Blvd # 41103d, Saint Paul, MN 55130 | 2013-03-23 |
| 1427394501 | Zongxee Lee | Registered Nurse | 1072 Payne Ave, St. Paul, MN 55130 | 2012-12-18 |
| 1740532753 | One Stop Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 1049 Payne Ave Suite C, St Paul, MN 55130 | 2012-10-15 |
| 1689923997 | Alexis Simmons | Counselor | 402 University Ave East, Suite A-127, Saint Paul, MN 55130 | 2012-08-31 |
| 1689804064 | Group Health Plan, Inc. | Durable Medical Equipment & Medical Supplies | 537 Phalen Blvd, Saint Paul, MN 55130 | 2009-07-21 |
| 1477756534 | Chad Everett Christensen | Chiropractor | 1073 Payne Ave, Saint Paul, MN 55130 | 2007-06-07 |
| 1922219021 | Qwik Urgent Care Clinic | Family Medicine | 1239 Payne Avenue, Saint Paul, MN 55130 | 2007-05-24 |
| 1275743981 | Yia Vang | Technician | 1100 Arkwright St., St. Paul, MN 55130 | 2007-05-23 |
| Find all providers in zip 55130 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| 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 Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851409395 | Diane Sione Tanabe | Ophthalmology | 280 Smith Ave N Ste 400, Lufkin Eye Clinic, Pa, Saint Paul, MN 55102-2473 | 2006-08-25 |
| 1124133764 | John C Foley | Ophthalmology | 1570 Concordia Ave, Suite 201, Saint Paul, MN 55104-4548 | 2006-08-21 |
| 1992743488 | Richard L Manka | Ophthalmology | 401 Phalen Blvd # Ms 41102e, Saint Paul, MN 55130 | 2006-06-04 |
| 1346294295 | Mark V Wedul | Ophthalmology | 1570 Concordia Ave Ste 202, Lexington Eye Associates Pa, Saint Paul, MN 55104-5345 | 2006-05-22 |
| 1538134614 | David J Eilers | Ophthalmology | 2221 Ford Pkwy, #210, Saint Paul, MN 55116-1800 | 2006-02-22 |
| 1972950814 | Edina Eye Physicians and Surgeons Pa | Ophthalmology | 4520 Centerville Rd, Saint Paul, MN 55127-3602 | 2016-05-20 |
| 1558604926 | John Charles Zeyer | Ophthalmology | 401 Phalen Blvd, Saint Paul, MN 55130 | 2013-04-03 |
| 1225324981 | Proeyecare Associates Pa | Ophthalmology | 1570 Concordia Ave, Suite 202, Saint Paul, MN 55104-5338 | 2011-06-21 |
| 1962525501 | John T Knapp | Ophthalmology | 2500 Como Ave, Saint Paul, MN 55108 | 2007-04-09 |
| 1790836633 | Gene W Chen | Ophthalmology | 2500 Como Ave, Saint Paul, MN 55108 | 2007-01-16 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55130 |
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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.