DR. KI TAE KIM (NPI# 1629106117) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629106117 |
| Entity Type | Individual |
| Full Name | DR. KI TAE KIM |
| Credential | D.C. |
| Practice Address |
206 N Bascom Ave Ste A San Jose CA 95128-1866 |
| Practice Telephone | 4089759606 |
| Practice Fax Number | 4089759616 |
| Mailing Telephone | 4089759606 |
| Mailing Fax Number | 4089759616 |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | DC27786 | CA | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851433882 | Ki H Kim | Acupuncturist | 3020 Wilshire Blvd Ste 220, Los Angeles, CA 90010-1120 | 2007-02-13 |
| 1972045565 | Ki Bong Kim | Pharmacist | 4025 Delridge Way Sw, #400, Seattle, WA 98106-1249 | 2016-11-14 |
| 1447683073 | Ki S Kim | Nurse Practitioner | 130 Park St Se Ste 100, Vienna, VA 22180-4626 | 2013-08-19 |
| 1548556665 | Ki H Kim | Family Medicine | 901 Nevin Ave, Richmond, CA 94801-3143 | 2011-06-27 |
| 1003133638 | Ki S Kim | Acupuncturist | 8202 Ne State Highway 104, Suite 105, Kingston, WA 98346-9454 | 2010-04-21 |
| 1295929636 | Ki Sook Kim | Preventive Medicine | 728 20th St, San Francisco, CA 94107 | 2007-08-29 |
| 1649286618 | Ki H Kim | Physical Medicine & Rehabilitation | 355 E Erie St, Chicago, IL 60611-3167 | 2006-07-31 |
| Street Address |
206 N BASCOM AVE STE A |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95128-1866 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227138 | Ruth Larsen | Social Worker | 850 S. Bascom Avenue, Suite 280, San Jose, CA 95128 | 2020-05-22 |
| 1265067185 | Of Two Minds Psychotherapy | Marriage & Family Therapist | 190 S. Bascom Ave, Ste 130, San Jose, CA 95128 | 2020-03-11 |
| 1982244166 | Cindy Pantoja Escobar | Behavior Technician | 100 O'connor Drive, Suites 21, San Jose, CA 95128 | 2020-01-15 |
| 1104460591 | Katherine Alexandra Misogas | Pharmacist | 777 Turner Dr # 330, San Jose, CA 95128 | 2019-10-29 |
| 1942842216 | Jodie Pierce | Marriage & Family Therapist | 871 Enborg Lane, San Jose, CA 95128 | 2019-10-08 |
| 1003466434 | Dong Mi Cha | Pharmacist | 777 Turner Dr Ste 330, San Jose, CA 95128 | 2019-09-17 |
| 1114571759 | Sleep Well Acupuncture, Inc | Acupuncturist | 1361 S Winchester Blvd Suite 206, San Jose, CA 95128 | 2019-08-01 |
| 1083277677 | Wellocity, Inc | Health Educator | 334 Santana Row, 318, San Jose, CA 95128 | 2019-04-18 |
| 1518428812 | Alexander Diaz | Radiology | 75 South Bascom Ave, San Jose, CA 95128 | 2019-03-28 |
| 1720542103 | Nanci R Price Inc | Chiropractor | 100 O'connor Dr., Ste 27, San Jose, CA 95128 | 2019-01-30 |
| Find all providers in zip 95128 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417556218 | Mandy Wong | Chiropractor | 3058 Marston Way, San Jose, CA 95148-3118 | 2020-10-22 |
| 1629688619 | Deepak Rattu | Chiropractor | 1754 Technology Dr Ste 120g, San Jose, CA 95110-1308 | 2020-08-04 |
| 1902423247 | Ernest Luong | Chiropractor | 360 Kiely Blvd Ste 215, San Jose, CA 95129-1300 | 2020-07-02 |
| 1518597681 | Kevin Tri Lam | Chiropractor | 508 Senter Ct, San Jose, CA 95111-3634 | 2020-01-17 |
| 1295370823 | Elise Leung | Chiropractor | 4323 Moorpark Ave Ste A, San Jose, CA 95129-2075 | 2019-11-06 |
| 1871155291 | Jee Won Suh | Chiropractor | 1645 Willow St Ste 100, San Jose, CA 95125-5112 | 2019-07-05 |
| 1174183610 | Kathy Huynh | Chiropractor | 1261 Lincoln Ave Ste 113, San Jose, CA 95125-3030 | 2019-06-17 |
| 1700441045 | Calvin Patrick Nell | Chiropractor | 5570 Sanchez Drive, Ste 100, San Jose, CA 95123 | 2019-05-02 |
| 1720542103 | Nanci R Price Inc | Chiropractor | 100 O'connor Dr., Ste 27, San Jose, CA 95128 | 2019-01-30 |
| 1386118560 | Yang Hsiang | Chiropractor | 1733 Chesterton Cir, San Jose, CA 95133-1534 | 2019-01-22 |
| Find all providers in SAN JOSE | ||||
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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.