Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Taeho Kim, PA

Individual provider Physician Assistant · NPI 1245751775

Taeho Kim, PA is a Physician Assistant in Walnut Creek, California. Qualified in 2017, 9 years ago. Practices with Stanford Health Care, a 3,085-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
9
Licensed in
CA
In the registry since
2017
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1808 San Miguel Dr
Walnut Creek, CA 94596-8606
Phone: (925) 528-2663
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 54634 (CA)

Record details

NPI number1245751775
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 6, 2017
Last updated in NPPESFebruary 11, 2025
Certification dateFebruary 11, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Stanford Health Care — 3085 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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