Individual Healthcare Provider
Jonathan Kim, DPM
Provider's NPPES record last updated: October 27, 2023
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1104220102
- Primary Specialty
- Podiatrist
- Practice Location
- Indio, California
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 21, 2026, 5:09 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Podiatrist
Podiatric Medicine & Surgery Service Providers
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
Taxonomy code 213E00000X
Provider-Reported License Information
- Podiatrist (California)
- E5392
Practice Locations
Practice Location
81709 Dr Carreon Blvd Ste D3
Indio, California 92201-5578
Phone: (760) 863-0070
Additional Practice Location
16465 Sierra Lakes Pkwy
Fontana, California 92336-1242
Phone: (909) 427-9522
Fax: (909) 697-2180
Additional Practice Location
728 N Euclid Ave
Ontario, California 91762-2712
Phone: (909) 984-5614
Fax: (909) 984-4759
Additional Practice Location
15944 Los Serranos Country Club Dr
Chino Hills, California 91709-3993
Phone: (909) 287-0677
Fax: (909) 631-2919
Record Information
- Enumeration Date
- October 20, 2014
- Provider's NPPES Record Last Updated
- October 27, 2023
- Certification Date
- April 18, 2022
- NPISignal NPPES Dataset
- August 2026
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