Sam Kim Physician Services Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SAM KIM PHYSICIAN SERVICES INC

Practice address

5400 Balboa Blvd Ste 326
Encino, CA 91316-5214

Phone

(818) 789-0941

Fax

(818) 789-6726

NPI assigned

Jan 2, 2020

Organization subpart

No

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

Authorized official

Name

Samuel Sungwon Kim, M.D.

Title

Ceo

Phone

(818) 939-4511

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770681600000",
    "number": "1104465541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 BALBOA BLVD STE 326",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165214",
            "telephone_number": "818-939-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 BALBOA BLVD STE 326",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913165214",
            "telephone_number": "818-789-0941",
            "fax_number": "818-789-6726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM KIM PHYSICIAN SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-02",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "SUNGWON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-939-4511",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Encino, CA
• Providers in Encino, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.