DR. JAE YUL KIM (NPI# 1023147014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023147014 |
| Entity Type | Individual |
| Full Name | DR. JAE YUL KIM |
| Credential | M.D. |
| Practice Address |
1500 Duarte Rd Duarte CA 91010-3012 |
| Mailing Address |
Po Box 512185 Los Angeles CA 90051-0185 |
| Practice Telephone | 6262564673 |
| Mailing Telephone | 6267753514 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-11-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | A85288 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558778100 | Jae Kim | Pharmacist | 14474 37th Ave, 1st Floor, Flushing, NY 11354-5934 | 2014-07-15 |
| 1215274865 | Jae S. Kim | Dentist | 1025 N Fillmore St, A, Arlington, VA 22201-6701 | 2013-01-15 |
| 1306112875 | Jae Hee Kim | Pharmacist | 1202 N 10th Pl Apt 1214, Renton, WA 98057-5635 | 2012-03-28 |
| 1548531536 | Jae Chil Kim | Physical Medicine & Rehabilitation | 107 Redcliff Dr, Jefferson Hills, PA 15025-3139 | 2012-01-23 |
| 1407143191 | Jae Man Kim | Acupuncturist | 3409 W Burbank Blvd, Burbank, CA 91505-2233 | 2011-07-01 |
| 1609168327 | Jae Y Kim | Otolaryngology | 2200 Wilson Blvd Ste 102-219, Arlington, VA 22201-3397 | 2011-05-12 |
| 1689849176 | Jae Hyun Kim | Prosthetist | 1918 Coliseum Blvd, Greensboro, NC 27403-3211 | 2008-04-25 |
| 1477745388 | Jae Woo Kim | Dentist | 403 N Five Points Rd, West Chester, PA 19380-4632 | 2007-08-14 |
| 1083832273 | Jae Gwon Kim | Dentist | 777 N. Rainbow Blvd., Ste. 395, Las Vegas, NV 89107 | 2007-04-23 |
| 1043359482 | Jae Seung Kim | Acupuncturist | 3400 W Olympic Bl, Ste207, Los Angeles, CA 90019-2122 | 2007-02-05 |
| Street Address |
1500 DUARTE RD |
| City | DUARTE |
| State | CA |
| Zip Code | 91010-3012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861498271 | Marwan G Fakih | Internal Medicine | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2005-06-22 |
| 1801403688 | Jia-chi Wang | Medical Genetics | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-09-25 |
| 1053923300 | Ying Moua | Social Worker | 1500 Duarte Rd, Duarte, CA 91010-3000 | 2020-08-18 |
| 1477163814 | Elise Sobotka | Genetic Counselor, MS | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-07-31 |
| 1033728217 | Gabriela Claudia Medrano | Nurse Practitioner | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-07-23 |
| 1538783295 | Lynn Kim | Occupational Therapist | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-05-29 |
| 1235759887 | Jessica Vuong | Pharmacist | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-04-23 |
| 1073133104 | Edward Thanasombat | Pharmacist | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-04-18 |
| 1285254300 | Tu Nguyen Doan Vuong | Pharmacist | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-04-18 |
| 1093344756 | Amy Marie Mcgovern | Nurse Practitioner | 1500 Duarte Rd, Duarte, CA 91010-3012 | 2020-04-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386266849 | Cheyenne King | Student in an Organized Health Care Education/Training Program | 1801 Huntington Drive, Duarte, Ca 91010, Duarte, CA 91010 | 2020-05-07 |
| 1114578028 | Cristian Gonzalez | Case Manager/Care Coordinator | 2250 E Foothill Ave, Pasadena, CA 91010 | 2019-09-23 |
| 1366932378 | Maisie Madrid | Marriage & Family Therapist | 1801 Huntington Drive, Duarte, CA 91010 | 2018-05-15 |
| 1598289571 | Bertha Maria Torres | Social Worker | 938 E. Huntington Drive, Unit A, Duarte, CA 91010 | 2017-08-01 |
| 1598292286 | Sheila Ramirez | Occupational Therapy Assistant | 2302 Citrus View Ave, Duarte, CA 91010 | 2017-05-12 |
| 1982059556 | Patricia Mendoza | Case Manager/Care Coordinator | 2502 E.huntington Dr., Duarte, CA 91010 | 2016-05-02 |
| 1770966178 | Sinziana Dumitra | Surgery | 1500 Durate Road California, Mob L001, Duarte, CA 91010 | 2015-07-02 |
| 1477940161 | Jin Sun L Bitar | Internal Medicine | 1500 Duarte Rd # Wing4, Duarte, CA 91010 | 2015-04-20 |
| 1659625622 | Jeanette Marie Petermann | Nurse Practitioner | 1036 East Huntington Drive, Duarte, CA 91010 | 2012-10-30 |
| 1649534397 | Nathaniel J Khoe Dds. Inc | Dentist | 1016 Huntington Drive, Duarte, CA 91010 | 2012-06-27 |
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| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760566079 | Chelvapilla Venkata Gunupati | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1500 E. Duarte Rd., Duarte, CA 91010-3200 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598370728 | North County Cvt Surgery Associates | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3156 Vista Way Ste 100, Oceanside, CA 92056-3694 | 2020-09-14 |
| 1417560756 | Valiana Vascular Institute Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2501 E Chapman Ave Ste 220, Fullerton, CA 92831-3108 | 2020-08-26 |
| 1891252474 | Miguel Puig Md A Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1430 Esplanade Ste 10, Chico, CA 95926-3366 | 2019-03-01 |
| 1598247991 | Pavel V Petrik Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1331 W Avenue J Ste 203, Lancaster, CA 93534-2954 | 2018-08-31 |
| 1942797378 | Sharon A Bogerty Md Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 105 N Bascom Ave Ste 101b, San Jose, CA 95128-1811 | 2018-04-20 |
| 1992231112 | Samer Kanaan Md A Professional Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 27451 Los Altos, Suite 290, Mission Viejo, CA 92691 | 2017-05-08 |
| 1073065512 | Central California Chest Surgery | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 729 N Medical Center Dr W Ste 223, Clovis, CA 93611-6885 | 2016-11-01 |
| 1407214612 | George Arnold Mulder | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1150 Laurel St, Pasadena, CA 91103-2329 | 2016-02-02 |
| 1760849905 | Steven R Gundry Md Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 555 E Tachevah Dr Ste 3w103, Palm Springs, CA 92262-5747 | 2016-01-19 |
| 1386018687 | Riyad Youssef Tarazi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 9120 Judicial Dr, Apt 7522, San Diego, CA 92122-6700 | 2015-11-24 |
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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.