Individual provider Active NPI

Eunsook Kim

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1295464469
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95021102 Issued in CA
Practice address
500 S Virgil Ave Ste 200
Los Angeles, CA 90020-1448
Phone
(213) 387-8000
NPI assigned
Jun 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95021102 CA Primary

Addresses

Primary practice location

500 S Virgil Ave Ste 200
Los Angeles, CA 90020-1448

Mailing address

500 S Virgil Ave Ste 200
Los Angeles, CA 90020-1448
Phone (213) 387-8000

Other names 1

  • Euni Kim Professional name

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
I20230428001670 CA Practitioner - Nurse Practitioner 4284099110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunny Hills Medical Center IncGroup PAC ID 5294105938, 4 clinicians

Practice addresses (Care Compare)

140 E Commonwealth Ave
Suite 100
Fullerton, CA 92832-1905
Phone (714) 572-3900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95021102CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sunny Hills Medical Center Inc. CurrentSince May 26, 2024 Accepting new patients

Locations

140 E Commonwealth Ave
Ste 100
Fullerton, CA 92832
Phone (714) 572-3900

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1295464469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S VIRGIL AVE STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201448",
            "telephone_number": "213-387-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S VIRGIL AVE STE 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201448",
            "telephone_number": "213-387-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "EUNSOOK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95021102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUNI",
            "last_name": "KIM",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.