Jungwoo Kim

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95033999 Issued in CA

Practice address

505 S Virgil Ave Ste 301
Los Angeles, CA 90020-1443

Phone

(213) 674-8282

NPI assigned

Feb 12, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Charlie Sam Nephrology

  • Primary Care Clinic/Center
  • Los Angeles, CA
  • NPI 1184029712
  NPD

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

{
    "created_epoch": "1739318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1184439465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 S BERENDO ST APT 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900045774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S VIRGIL AVE STE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201443",
            "telephone_number": "213-674-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JUNGWOO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-12",
        "last_updated": "2025-02-12",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95033999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jung S Kim
• Jung Soon Kim, SUPPORT SPECIALIST
• Jung Sun Kim, L.AC.
• Jung Yun Kim, PHD
• Jungai Kim
• Junho Kim
• Justin Kim
• Justin Kim, DPT
• Justin Kim
• Jutae Kim

• Family Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.