OrganizationActive
Icu423r
NPI 1528752300 · Integrative Medicine Physician · Mesa, AZ
Provider details
- NPI number
- 1528752300
- Entity type
- Organization
- Primary specialty
- Integrative Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kiup Kim, Owner(602) 730-6438
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Community/Behavioral Health Agency251S00000X
Agencies
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1101 W Guadalupe Rd Ste 1
Mesa, AZ 85210-7601
Phone: (480) 788-5621
Fax: (480) 779-1277
Street-level locationGet directions
Mailing address
202 E Earll Dr Ste 360
Phoenix, AZ 85012-2677
Registry dates
- Enumerated
- 2023-06-06
- Last updated
- 2023-06-06
- Certified
- 2023-06-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.