Sung Im, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A117206 Issued in CA

Practice address

1225 Wilshire Blvd
Los Angeles, CA 90017-1901

Phone

(213) 977-2121

NPI assigned

Dec 31, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

University of Virginia School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Citrus Valley Anesthesia Medical GroupGroup PAC ID 8628982501, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Citrus Valley Anesthesia Medical Group

  • Anesthesiology Physician
  • West Covina, CA
  • NPI 1912920331
  Medicare reassignment Care Compare group
• Allied Anesthesia Medical Group Inc

  • Anesthesiology Physician
  • Orange, CA
  • NPI 1346267267
  Medicare reassignment NPD
• Han Orthopaedics Inc

  • Health Service Clinic/Center
  • Los Angeles, CA
  • NPI 1316348253
  Medicare reassignment NPD
• Emanate Health Medical Center

  • General Acute Care Hospital
  • Covina, CA
  • NPI 1982629440
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Emanate Health Medical Center

  • General Acute Care Hospital
  • West Covina, CA
  • NPI 1063441293
  Care Compare affiliation
• Emanate Health Medical Center

  • Psychiatric Hospital Unit
  • Covina, CA
  • NPI 1215063151
  Care Compare affiliation
• Emanate Health Medical Center

  • General Acute Care Hospital
  • Covina, CA
  • NPI 1982629440
  Care Compare affiliation

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1316122104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 E TEMPLE WAY",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917912329",
            "telephone_number": "703-344-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171901",
            "telephone_number": "213-977-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IM",
        "first_name": "SUNG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-31",
        "last_updated": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A117206",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A117206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1011 Baldwin Park Blvd",
            "city": "Baldwin Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "917065806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jonah Im
• Kenneth Im, DPT
• Kyuseok Im
• Moon Young Im VI, D.C.
• Soo Jung Im, MD
• William Chul Kyu Im
• Yang Taek Im, LA.C
• Gwen Emiko Imada, PHARM. D.
• Karen Kay Imagawa, MD
• Dorothy K Imai, PHD MFT

• Anesthesiology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 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.
• 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.

Verify at the official NPI Registry.