Individual ProviderJames S. KimEmergency MedicineAllopathic & Osteopathic PhysiciansPractice Address4445 Magnolia Ave, Riverside, CA 92501-4135(909) 788-3000(510) 350-2600PECOS EnrollmentThis provider is enrolled in PECOS as JAMES KIM.Based on the most recent information from CMS, provider James S. Kim is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1861508038Provider TypeIndividualFull NameKim, James S.CredentialM.DGenderMaleSole ProprietorNoEnumeration Date8/21/2006Last Updated11/7/2007Contact InformationPractice LocationPractice Address4445 Magnolia Ave, Riverside, CA 92501-4135Phone(909) 788-3000FaxUnlisted FaxMailing LocationMailing Address2100 Powell St, Ste 900, Emeryville, CA 94608-1826Phone(510) 350-2600Fax(510) 879-9100Provider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicenseA77334CaliforniaProvider IdentifiersIDDescriptionIssuerID00A773340DescriptionMedicaidIssuerUnlistedCalifornia