Active NPI
Esther Songyon Kim
- Pediatrics Physician
- Sylmar, CA
National Provider Identifier
1336670249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 129998
- Practice address
- 14445 Olive View Dr # S
Sylmar, CA 91342-1437 - Phone
- (747) 210-3233
- NPI assigned
- Mar 22, 2017
- Last updated
- Oct 15, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 129998 | CA | Primary |
Addresses
Primary practice location
14445 Olive View Dr # S
Sylmar, CA 91342-1437
Mailing address
14445 Olive View Dr # S
Sylmar, CA 91342-1437
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230413001876 | CA | Order and Referring Only - Pediatric Medicine | 0547635161 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 129998 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728950400000",
"number": "1336670249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14445 OLIVE VIEW DR # S",
"city": "SYLMAR",
"state": "CA",
"postal_code": "913421437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14445 OLIVE VIEW DR # S",
"city": "SYLMAR",
"state": "CA",
"postal_code": "913421437",
"telephone_number": "747-210-3233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "ESTHER",
"middle_name": "SONGYON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-22",
"last_updated": "2024-10-15",
"certification_date": "2024-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "129998",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sylmar, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.