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Deactivated NPI 1619064904 Deactivated / Inactive NPI Male Practitioner

Dr. Young Song Kim , MD

Surgery • La Quinta, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Young Song Kim has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 06, 2006
NPI Deactivation Date October 16, 2024
Total Practice Duration ~18 Years of Practice (2006 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. Young Song Kim, MD was a registered Surgery practicing in La Quinta, CA. Throughout an active medical career spanning 18 years, Dr. Kim provided care at the practice location at 80539 PEBBLE BCH until profile deactivation on 2024-10-16.

Practice Location & Contact Primary Location

Practice Address

80539 Pebble Bch

La Quinta, CA 922534627

Telephone 7605640241
Fax 7605645941
Associated Practice Facility / Clinic
🏢 Young Song Kim, Md, Inc. Facility NPI 1548360399

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in La Quinta, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 24.0 Yrs
State Avg: 27.4 Yrs
Regional Practice Density
3 Specialists

Practicing in La Quinta, CA (3346 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License CA C36986

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 16, 2024

Record deactivated on October 16, 2024

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 80539 PEBBLE BCH, LA QUINTA, CA 922534627 (Tel: 7605640241)

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Updated Business Mailing Address July 08, 2007

Registered at 80539 PEBBLE BCH, LA QUINTA, CA 922534627 (Tel: 7605640241)

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Provider Name / Credentials Updated July 08, 2007

Recorded as YOUNG SONG KIM, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Surgery (License #C36986 in CA)

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Initial NPI Registration & Enumeration October 06, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1619064904
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 06, 2006
Last Update: July 08, 2007
Deactivation Date: October 16, 2024

Mailing Address

80539 Pebble Bch

La Quinta, CA 922534627

Phone: 7605640241

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.