Individual provider Active NPI

Sori Kim, NP

  • Family Nurse Practitioner
  • Loma Linda, CA
National Provider Identifier
1083363980
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95026540 Issued in CA
Practice address
11234 Anderson St # MC-1516
Loma Linda, CA 92350-1716
Phone
(909) 558-4000
NPI assigned
Mar 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 193895 TN
Registered Nurse 163W00000X 95281041 CA
Family Nurse Practitioner 363LF0000X 31318 TN
Family Nurse Practitioner 363LF0000X 95026540 CA Primary

Addresses

Primary practice location

11234 Anderson St # MC-1516
Loma Linda, CA 92350-1716

Mailing address

11234 Anderson St # MC-1516
Loma Linda, CA 92350-1716
Phone (909) 558-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241216003813 CA Practitioner - Nurse Practitioner 5991232886 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
193895TNMDRegistered Nurse
31318TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sac Health System Current Accepting new patients
Sac Health System CurrentSince Feb 20, 2025 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Dec 16, 2024 Accepting new patients
Sac Health System CurrentSince Feb 20, 2025 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Dec 16, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Pediatric Health Care, PC PastSince Mar 1, 2022 Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11234 Anderson St
#1516
Loma Linda, CA 92350
Phone (909) 558-4884

11370 Anderson St
#3625
Loma Linda, CA 92354
Phone (909) 558-2850

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

11370 Anderson St
Ste 2600
Loma Linda, CA 92354
Phone (909) 558-2890

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

250 S G St
San Bernardino, CA 92410
Phone (909) 771-2990

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

901 San Bernardino Rd
Ste 104
Upland, CA 91786
Phone (909) 542-2779

Interoperability endpoints

  • Direct secure messaging: sjung1236529@direct.llu.edu

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1083363980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST # MC-1516",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501716",
            "telephone_number": "909-558-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON ST # MC-1516",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501716",
            "telephone_number": "909-558-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SORI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-20",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "193895",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95281041",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "31318",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95026540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.