MICHAEL JAE BUM KIM D.P.M. NPI 1073951190

NPI Information

  • NPI: 1073951190
  • Provider Name: MICHAEL JAE BUM KIM, D.P.M.
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 9353 FAIRWAY VIEW PL STE 100
    RANCHO CUCAMONGA, CA
    ZIP 91730
  • Phone: (909) 858-2772

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NPI Details

Michael Jae Bum Kim, D.P.M. is a foot and ankle surgery podiatrist in Rancho Cucamonga, CA with 12 years of experience. Michael Jae Bum Kim, D.P.M. NPI is 1073951190. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TEMPLE UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Graduation Year:2013

The provider's business location address is:

9353 FAIRWAY VIEW PL STE 100
RANCHO CUCAMONGA, CA
ZIP 91730-972
Phone: (909) 858-2772
Fax: (909) 300-6324

The NPI 1073951190 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Removal of fingernails or toenails, 6 or more nails (HCPCS:11721)
  • Removal of noncancer thickened skin growth, 2-4 growths (HCPCS:11056)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • X-ray of foot, minimum of 3 views (HCPCS:73630)
  • Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional (HCPCS:99211)
  • Lower limb (leg) arthroscopy (minimally invasive joint repair) (HCPCS:NAN15)

The enumeration date for this NPI number is 6/11/2013 and was last updated on 2/23/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213ES0103XPodiatristFoot & Ankle Surgery5901002476MICHIGANNo
2213ES0103XPodiatristFoot & Ankle SurgeryE5294CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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