BOOIL KIM D.O.
NPI 1508250804
General Practice in Rancho Cucamonga, CA

Q: What is Booil Kim's NPI number?

The NPI number for Booil Kim is 1508250804. It was assigned to this individual provider in the NPPES registry on March 25, 2015.

Q: What is Booil Kim's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Booil Kim was last updated on July 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 25, 2015PECOS EnrolledAccepts Medicare Assignment

9405 FAIRWAY VIEW PL, RANCHO CUCAMONGA, CA 91730(909) 481-7345 Get Directions Write a Review

NPPES record last updated: July 6, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 6, 2023, Aug 11, 2022 (2 updates tracked since 2022).

On this page

About Booil Kim D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOOIL KIM D.O. (NPI 1508250804) is an individual general practice provider in Rancho Cucamonga, California, licensed in California (20A14985) and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1508250804

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameBOOIL KIMCredential: D.O.

Location Address9405 FAIRWAY VIEW PLRancho Cucamonga, CA 91730-0932

Mailing Address9405 Fairway View PlRancho Cucamonga, CA 91730-0932

Phone(909) 481-7345

Sole ProprietorYes

Medical School CMSOtherGraduated 2015

Enumeration DateMarch 25, 2015

Last NPPES UpdateJuly 6, 20232 updates tracked since enumeration

NPPES CertifiedJuly 6, 2023

✔ NPI 1508250804 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in CA · 20A14985

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedInternal MedicineTaxonomy 207R00000X · License 20A14985 (CA)

9405 FAIRWAY VIEW PL, Rancho Cucamonga, CA 91730

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Booil Kim D.o. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1254711575

PECOS Enrollment IDI20220705001694

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NESREEN SAAD DPT

Physical Therapist (Orthopedic)