Kyk Medical Professional Corporation

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

KYK MEDICAL PROFESSIONAL CORPORATION

Practice address

13522 Newport Ave Ste 102
Tustin, CA 92780-3707

Phone

(714) 388-6816

Fax

(832) 406-3968

NPI assigned

Apr 22, 2025

Organization subpart

No

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

Authorized official

Name

Dr. Ki-Yoon Kim, MDNPI 1558715110

Title

Owner

Phone

(714) 388-6816

Specialties & licenses 1

Addresses

Other names 2

• KYK MEDICAL, INC Doing business as
• Corporation Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ki-Yoon Kim, M.D.

  • Gastroenterology Physician
  • San Diego, CA
  • NPI 1558715110
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788480000000",
    "number": "1093502148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 OVERBROOK",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926202169",
            "telephone_number": "714-388-6816",
            "fax_number": "832-406-3968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13522 NEWPORT AVE STE 102",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803707",
            "telephone_number": "714-388-6816",
            "fax_number": "832-406-3968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYK MEDICAL PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-22",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "KI-YOON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-388-6816",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KYK MEDICAL, INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Corporation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Miki Kusaka
• Donald Kuskin, PHYSICAL THERAPIST
• Jae H. Kwak, D.M.D.
• Grace Eun Kwon, D.O.
• Susan Kwon, DMD
• Laboratory Corporation of America
• Labwest, Inc
• Wendy Diane Lagreen, PSY.D.
• Mai A Lai
• Nan Lai, M.D.

• Gastroenterology Physician in Tustin, CA
• Providers in Tustin, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.