PAUL JAEGU KIM (NPI# 1417104837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417104837 |
| Entity Type | Individual |
| Full Name | PAUL JAEGU KIM |
| Credential | M.D. |
| Practice Address |
200 W Arbor Dr San Diego CA 92103-9000 |
| Mailing Address |
Po Box 232410 San Diego CA 92193-2410 |
| Practice Telephone | 8586578530 |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2017-10-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
A109213 | CA | Allopathic & Osteopathic Physicians |
| Y | 207RA0001X |
Internal Medicine Specialization: Advanced Heart Failure and Transplant Cardiology |
A109213 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A869820 | 05 |
| 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 |
200 W ARBOR DR |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-9000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043215502 | Alfredo B. Tiu | Internal Medicine | 200 W Arbor Dr, Owen Clinic, San Diego, CA 92103-9001 | 2005-06-20 |
| 1841806536 | Kevin Thai Nguyen | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-09-18 |
| 1003421256 | Jessica Lynette Montoya | Psychologist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-09-14 |
| 1013522838 | Julianna L Gorder | Psychologist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-09-09 |
| 1992318828 | Yodit Mekonnen Teklu | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-08-29 |
| 1356954283 | Dalia Siada | Dietitian, Registered | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-08-29 |
| 1699383588 | Rachael Ashley Gordon | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-07-17 |
| 1124646906 | Jeffrey David Bernstein | Student in an Organized Health Care Education/Training Program | 200 W Arbor Dr, Mc 1234, San Diego, CA 92103-9000 | 2020-07-08 |
| 1639796071 | Darcie D Brown | Marriage & Family Therapist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-07-01 |
| 1194340919 | Han B Dinh | Pharmacist | 200 W Arbor Dr, San Diego, CA 92103-9000 | 2020-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 207RA0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Advanced Heart Failure and Transplant Cardiology |
| Specialists in Advanced Heart Failure and Transplant Cardiology would participate in the inpatient and outpatient management of patients with advanced heart failure across the spectrum from consideration for high-risk cardiac surgery, cardiac transplantation, or mechanical circulatory support, to pre-and post-operative evaluation and management of patients with cardiac transplants and mechanical support devices, and end-of-life care for patients with end-stage heart failure. |
| Notes: Source: American Board of Internal Medicine, www.abim.org [7/1/2015: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073161329 | Andrea Boettcher | Internal Medicine | 7901 Frost St, San Diego, CA 92123-2701 | 2019-08-29 |
| 1063701068 | Nicholas William Wettersten | Internal Medicine | 200 W Arbor Dr, San Diego, CA 92103 | 2011-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386162949 | Faculty Physicians and Surgeons of Llusm | Internal Medicine | 197 E Caroline St, San Bernardino, CA 92408 | 2017-09-05 |
| 1285722686 | Anita Dominique Szady | Internal Medicine | 2 Bon Air Rd Ste 100, Larkspur, CA 94939-1144 | 2006-10-11 |
| 1124681887 | Victoria L Bazanos | Internal Medicine | 11234 Anderson St, Schuman Pavilion Sp-1617, Loma Linda, CA 92354 | 2019-04-18 |
| 1720346240 | Behram Parvez Mody | Internal Medicine | 333 City Blvd W Ste 400, Orange, CA 92868-2994 | 2012-05-03 |
| 1346515442 | Kimberly N Hong | Internal Medicine | 9434 Medical Center Dr, La Jolla, CA 92037-1337 | 2012-03-21 |
| 1417186438 | Nancy Luo | Internal Medicine | 3939 J St Ste 230, Sacramento, CA 95819 | 2009-07-12 |
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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.