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

Ted Kim

Individual provider Physician Assistant · NPI 1174303713

Ted Kim is a Physician Assistant in Santa Monica, California. Graduated from Stanford University School of Medicine in 2025, 1 year ago. Licensed in California.

Years since qualifying
1
Trained at
Stanford University School of Medicine
Licensed in
CA
In the registry since
2023

Practice location Address checks out

2811 Wilshire Blvd Ste 414
Santa Monica, CA 90403-4804
Phone: (310) 552-9999
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA66314 (CA)

Record details

NPI number1174303713
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 2, 2023
Last updated in NPPESOctober 29, 2025
Certification dateOctober 29, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolSTANFORD UNIVERSITY SCHOOL OF MEDICINE
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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