ANGIE BYUNG JU KIM (NPI# 1144735895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144735895 |
| Entity Type | Individual |
| Full Name | ANGIE BYUNG JU KIM |
| Credential | PA-C |
| Practice Address |
1855 N Fair Oaks Ave Pasadena CA 91103-1620 |
| Mailing Address |
455 W Montana St Pasadena CA 91103-1327 |
| Practice Telephone | 6269931221 |
| Enumeration Date | 2017-12-04 |
| Last Update Date | 2019-11-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 55199 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2501 E Chapman Ave, Orange, CA 928693204 | 7146331011 | |
| 2212 E 4th St Ste 103, Santa Ana, CA 927053871 | 7145717700 | |
| 2251 N Harbor Blvd, Fullerton, CA 928352601 | 7144496230 | |
| 26800 Crown Valley Pkwy Ste 150, Mission Viejo, CA 926918018 | 9492762111 | 9492762116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326657099 | Angie Kim | Nurse Practitioner | 60 N Stygler Rd, Gahanna, OH 43230-2435 | 2020-07-28 |
| 1205356029 | Angie Eunji Kim | Counselor | 1513 E Chapman Ave, Fullerton, CA 92831-4013 | 2017-06-22 |
| 1881001634 | Angie Kim | Pharmacist | 932 E Front St, Port Angeles, WA 98362-4015 | 2014-07-14 |
| 1942585658 | Angie Y Kim | Dentist | 2947 S Buckner Blvd, Suite 100, Dallas, TX 75227-6952 | 2011-10-13 |
| Street Address |
1855 N FAIR OAKS AVE |
| City | PASADENA |
| State | CA |
| Zip Code | 91103-1620 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154300630 | Taska K Moore | Obstetrics & Gynecology | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2006-01-12 |
| 1164997144 | Trindiad Flores | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2018-10-05 |
| 1467945287 | Lisa Michelle Cherqaoui | Registered Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2018-06-07 |
| 1124520267 | Ma. Cecilia Alonzo Verceles | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2018-03-05 |
| 1134621329 | Veronica Kay Helmuth | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2018-03-02 |
| 1740781723 | Jacqueline Flores | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2018-02-23 |
| 1790299675 | Graciela Quevedo | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2017-11-30 |
| 1417461526 | Merci Taylor | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2017-11-28 |
| 1164936126 | Marisol Bonner | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2017-11-28 |
| 1366954828 | Jessica Michelle De La Mora | Licensed Vocational Nurse | 1855 N Fair Oaks Ave, Pasadena, CA 91103-1620 | 2017-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013407071 | Sean Patrick Comingore | Counselor | 1680 N. Fair Oaks Ave., Pasadena, CA 91103 | 2018-05-15 |
| 1093230252 | John Jesus Smith | Rehabilitation Practitioner | 867 Fair Oaks Ave, Pasadena, CA 91103 | 2017-08-09 |
| 1760906085 | Roberto Sotelo Jr. | Licensed Vocational Nurse | 867 North Fair Oaks Ave., Pasadena, CA 91103 | 2017-07-28 |
| 1477076172 | Towana Danielle Hooks | Rehabilitation Practitioner | 867 North Fair Oaks, Pasadena, CA 91103 | 2017-07-25 |
| 1437671807 | Yolanda Centeno | Marriage & Family Therapist | 867 Fairoaks., Pasadena, CA 91103 | 2017-07-07 |
| 1306366604 | Joseph Anthony Zepeda | Counselor | 1680 N. Fair Oaks Avenue, Pasadena, CA 91103 | 2017-06-27 |
| 1922537372 | Chaznii Bradford | Licensed Vocational Nurse | 867 N. Fair Oaks, Pasadena, CA 91103 | 2017-06-08 |
| 1629505425 | Wassim Ammary | Pharmacist | 1855 South Fair Oaks Ave, Pasadena, CA 91103 | 2017-05-11 |
| 1679005920 | Grace Caroline Seto | Marriage & Family Therapist | 236 W. Mountain St, Suite 202d, Pasadena, CA 91103 | 2017-03-28 |
| 1225575293 | Catherine Lynn Gray | Psychologist | 30 North Raymond Avenue, Suite 403, Pasadena, CA 91103 | 2017-01-27 |
| Find all providers in zip 91103 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710593397 | Elyssa Summer Mccormack | Physician Assistant | 275 N Oakland Ave Apt 2, Pasadena, CA 91101-1647 | 2020-09-19 |
| 1356951941 | Emily Lynn Yang | Physician Assistant | 3219 Fairpoint St, Pasadena, CA 91107-1202 | 2020-08-07 |
| 1326675414 | Melissa Real | Physician Assistant | 845 Wright Ave, Pasadena, CA 91104-4466 | 2020-03-26 |
| 1164064762 | Nikita Phiroz Engineer | Physician Assistant | 4102 Woodlawn Ave Ste 210, Pasadena, TX 77504-1949 | 2019-10-15 |
| 1275189979 | Robert Hennington | Physician Assistant | 111 Red Bluff Rd, Pasadena, TX 77506-1530 | 2019-08-18 |
| 1306329586 | Sofia Fiona Knoppel-calas | Physician Assistant | 215 N Allen Ave, Pasadena, CA 91106-1601 | 2018-09-13 |
| 1598136517 | Cara Kylie Jugant | Physician Assistant | 3450 Fairpoint St, Pasadena, CA 91107-1207 | 2015-10-16 |
| 1962870451 | Christopher Fong | Physician Assistant | 455 W Montana St, Pasadena, CA 91103-1327 | 2015-09-14 |
| 1629451380 | Mary Evelyn Smith | Physician Assistant | 2080 San Pasqual St, Pasadena, CA 91107-5157 | 2015-06-30 |
| 1861899445 | Ryan Whitworth | Physician Assistant | 140 N Lake Ave, Pasadena, CA 91101-1836 | 2014-11-26 |
| Find all providers in PASADENA | ||||
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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.