Active NPI
Eunsook Kim
- Family Nurse Practitioner
- Los Angeles, CA
National Provider Identifier
1295464469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95021102
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 95021102 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sunny Hills Medical Center Inc. | Current | 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.
-
- Internal Medicine Physician
- Fullerton, CA
- NPI 1750008017
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.