Sonya Young Kim, M.D., MBA

Primary specialty

Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X

License

A79002 Issued in CA

Practice address

1 Devonshire Blvd Apt 8
San Carlos, CA 94070-1758

Phone

(415) 314-1005

Fax

(888) 959-8346

NPI assigned

Apr 5, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Other identifiers 2

Other names 1

• Dr. Sonya Young Kim Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Doctor of Medicine

State licenses

Practice roles

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.

• Clinical Laboratories of Hawaii LLP

  • Clinical Medical Laboratory
  • Ewa Beach, HI
  • NPI 1134195357
  NPD (past)

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1225353022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DEVONSHIRE BLVD APT 8",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940701758",
            "telephone_number": "415-314-1005",
            "fax_number": "888-959-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DEVONSHIRE BLVD APT 8",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940701758",
            "telephone_number": "415-314-1005",
            "fax_number": "888-959-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SONYA",
        "middle_name": "YOUNG",
        "name_prefix": "Dr.",
        "credential": "M.D., MBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-05",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PT0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": "CA",
            "license": "A79002",
            "primary": false
        },
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "CA",
            "license": "A79002",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A79002",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "CA",
            "license": "A79002",
            "primary": false
        },
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "CA",
            "license": "A79002",
            "primary": false
        },
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "CA",
            "license": "A79002",
            "primary": false
        },
        {
            "code": "207PH0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "A79002",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HI STATE MEDICAL LICENSE",
            "identifier": "MD 12795",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA STATE MEDICAL LICENSE",
            "identifier": "A79002",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONYA",
            "last_name": "KIM",
            "middle_name": "YOUNG",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Kienitz
• Grace S Kim, M.D.
• Janice Kim, MD
• Ji Yei Kim, PHARM.D.
• Julie C Kim, OD
• Yeon Soo Kim
• Glencora N King
• Sarah Kirby
• Aleksandr Klebaner, DDS
• Marianna Klebanov, MFT AND LPCC

• Sports Medicine (Emergency Medicine) Physician in San Carlos, CA
• Providers in San Carlos, CA by specialty
• Sports Medicine (Emergency Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.