CHARLES CHOL BAE KIM MD NPI 1225564818

NPI Information

  • NPI: 1225564818
  • Provider Name: CHARLES CHOL BAE KIM, MD
  • Classification: Family Medicine - 207QA0505X
  • Specialization: Adult Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 14642 NEWPORT AVE STE 105
    TUSTIN, CA
    ZIP 92780
  • Phone: (714) 831-1112

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NPI Details

Charles Chol Bae Kim, MD is an adult medicine family medicine in Tustin, CA with 45 years of experience. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. Charles Chol Bae Kim, MD NPI is 1225564818. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

14642 NEWPORT AVE STE 105
TUSTIN, CA
ZIP 92780-058
Phone: (714) 831-1112
Fax: (714) 486-2309

The NPI 1225564818 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), Power Mobility Devices.

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.

  • Therapy procedure using ultrasound (HCPCS:97610)
  • Removal of muscle and/or tissue, each additional 20.0 sq cm or less (HCPCS:11046)
  • Removal of muscle and/or tissue, 20.0 sq cm or less (HCPCS:11043)
  • Removal of skin and tissue, 20.0 sq cm or less (HCPCS:11042)
  • Established patient home visit, typically 25 minutes (HCPCS:99348)

The enumeration date for this NPI number is 5/3/2017 and was last updated on 10/13/2021.

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
1207Q00000XFamily Medicine54481ARIZONANo
2207QG0300XFamily MedicineGeriatric MedicineC-129160CALIFORNIANo
3207QA0505XFamily MedicineAdult MedicineC129160CALIFORNIAYes

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: 11/21/2025

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