Mary Kim (NPI# 1780724435, PAC ID# 6608038948) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL MEDICINE AND REHABILITATION.
| Nation Provider ID (NPI) | 1780724435 |
| PAC ID by PECOS | 6608038948 |
| Professional Enrollment ID | I20120502000165 |
| Full Name | Mary Kim |
| Organization Legal Name | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| Address |
11406 Loma Linda Dr Suite 300 Loma Linda CA 92354-3711 |
| Phone Number | 9095586277 |
| Gender | F |
| Medical School | LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2006 |
| Primary Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| Secondary Specialties | PAIN MANAGEMENT |
| Group Practice PAC ID | 1153227814 |
| Number of Group Practice Members | 912 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050327 | LOMA LINDA UNIVERSITY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 11406 Loma Linda Dr, Suite 300, Loma Linda, CA 92354-3711 | 9095586277 | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| Organization Legal Name | FACULTY PHYSICIANS AND SURGEONS OF LLUSM |
| Physicians | 1002 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ecler E Jaqua | Family Medicine | Faculty Physicians and Surgeons of Llusm | 25828 Redlands Blvd, Suite 102, Redlands, CA 92373-8450 |
| Lorraine Reverson Ray | Pediatric Medicine | Faculty Physicians and Surgeons of Llusm | 11441 Heacock St, Suite C, Moreno Valley, CA 92557-7907 |
| Mauna-loa Rodgers-blankenship | Nurse Practitioner | Faculty Physicians and Surgeons of Llusm | 81 S Highland Springs Ave, Beaumont, CA 92223-3170 |
| Davin Chu | Physical Medicine and Rehabilitation | Faculty Physicians and Surgeons of Llusm | 11406 Loma Linda Dr, Suite 300, Loma Linda, CA 92354-3711 |
| Ramachandran Pillai Promod Kumar | Neurosurgery | Faculty Physicians and Surgeons of Llusm | 16041 Kamana Rd A, Apple Valley, CA 92307-1331 |
| Biswas Joshi | Pulmonary Disease | Faculty Physicians and Surgeons of Llusm | 250 E Caroline St, Suite J, San Bernardino, CA 92408-3758 |
| Alexandra J Bandy | Nurse Practitioner | Faculty Physicians and Surgeons of Llusm | 11370 Anderson St, B100, Loma Linda, CA 92354-3400 |
| Brian R Hu | Urology | Faculty Physicians and Surgeons of Llusm | 11234 Anderson St, Loma Linda, CA 92354-2804 |
| Brian Wolk | Emergency Medicine | Faculty Physicians and Surgeons of Llusm | 328 Commercial Rd, Suite 101, San Bernardino, CA 92408-3766 |
| Ronald Bruce Johnson | Obstetrics/gynecology | Faculty Physicians and Surgeons of Llusm | 2195 Club Ctr Dr, Suite A, San Bernardino, CA 92408-4162 |
| Street Address |
11406 LOMA LINDA DR SUITE 300 |
| City | LOMA LINDA |
| State | CA |
| Zip | 92354-3711 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Davin Chu | Physical Medicine and Rehabilitation | Faculty Physicians and Surgeons of Llusm | 11406 Loma Linda Dr, Suite 300, Loma Linda, CA 92354-3711 |
| Shahzad R Farukhi | Internal Medicine | 11406 Loma Linda Dr, Loma Linda, CA 92354-3711 | |
| Keisha L Baldeosingh | Gastroenterology | 11406 Loma Linda Dr, Loma Linda, CA 92354-3711 | |
| Christopher Charles Tarver | Physical Medicine and Rehabilitation | Faculty Physicians and Surgeons of Llusm | 11406 Loma Linda Dr, Suite 300, Loma Linda, CA 92354-3711 |
| Murray E Brandstater | Physical Medicine and Rehabilitation | Faculty Physicians and Surgeons of Llusm | 11406 Loma Linda Dr, Suite 300, Loma Linda, CA 92354-3711 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John Beld | Physical Therapy | Physiotherapy Associates Inc | 10459 Mountain View Ave, Loma Linda, CA 92354-2033 |
| Leisure Yu | Orthopedic Surgery | Leisure Yu Md Inc | 10459 Mountain View Ave D, Loma Linda, CA 92354-2033 |
| Kelsey Jillane Kellar | Physical Therapy | Physiotherapy Associates Inc | 10459 Mountain View Ave, Loma Linda, CA 92354-2033 |
| Joshua Dean Elloway | Physical Therapy | Physiotherapy Associates Inc | 10459 Mountain View Ave, Loma Linda, CA 92354-2033 |
| Matthew Haus | Physical Therapy | Physiotherapy Associates Inc | 10459 Mountain View Ave, Loma Linda, CA 92354-2033 |
| Dennis R Breese | Physical Therapy | Physiotherapy Associates Inc | 10459 Mountain View Ave, Loma Linda, CA 92354-2033 |
| John Tuan Vy | Physical Therapy | Physiotherapy Associates Inc | 10459 Mountain View Ave, Loma Linda, CA 92354-2033 |
| Jose D Alvarez | Physical Therapy | Physiotherapy Associates Inc | 10459 Mountain View Ave, Loma Linda, CA 92354-2033 |
| Brittany Beckwith | Physical Therapy | Physiotherapy Associates Inc | 10459 Mountain View Ave, Loma Linda, CA 92354-2033 |
| Brian R Hu | Urology | Faculty Physicians and Surgeons of Llusm | 11234 Anderson St, Loma Linda, CA 92354-2804 |
| Find all physicians in zip 92354 | |||
| City | LOMA LINDA |
| Zip Code | 92354 |
| Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| City + Specialty | LOMA LINDA + PHYSICAL MEDICINE AND REHABILITATION |
Please comment or provide details below to improve the information on Mary Kim.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.