Shannon Leung Kim

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A162026 Issued in CA

Practice address

8910 Villa la Jolla Drive
Suite 110
La Jolla, CA 92037

Phone

(858) 203-4962

NPI assigned

Jun 6, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

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.

• University Medical Associates of the Medical University of South Carol

  dba MUSC Physicians

  • Multi-Specialty Clinic/Center
  • Charleston, SC
  • NPI 1043241110
  Medicare reassignment NPD
• University Medical Associates of the Medical University of South Carol

  dba MUSC Physicians

  • Obstetrics & Gynecology Physician
  • Charleston, SC
  • NPI 1013934629

  Pediatrics

  NPD
• University Medical Associates of the Medical University of South Carol

  dba MUSC PHysicians

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1982678496
  NPD
• Rady Children's Hospital San Diego

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Diego, CA
  • NPI 1851303994
  NPD (past)
• Regents of the University of California

  dba UCSD Pediatric and Adolescent Associates

  • Pediatric Adolescent Medicine Physician
  • San Diego, CA
  • NPI 1013035716

  Pediatrics

  NPD (past)
• Regents of the University of California

  dba Ucsd Medical Center Pharmacy

  • Pharmacy
  • San Diego, CA
  • NPI 1598786576
  NPD (past)
• Regents of the University of California Ucsd Head and Neck Surgery

  • Otolaryngology Physician
  • San Diego, CA
  • NPI 1679509962
  NPD (past)
• Medical University Hospital Authority

  • Certified Registered Nurse Anesthetist
  • Charleston, SC
  • NPI 1255305876
  NPD (past)

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

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1588077564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7910 FROST STREET",
            "address_2": "SUITE 350",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92123",
            "telephone_number": "858-496-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8910 VILLA LA JOLLA DRIVE",
            "address_2": "SUITE 110",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "92037",
            "telephone_number": "858-203-4962"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7910 Frost Street",
            "address_2": "Suite 350",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "92123",
            "country_code": "US",
            "telephone_number": "858-496-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIM",
        "first_name": "SHANNON",
        "middle_name": "LEUNG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-06",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A162026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Kim
• Robert C. Kim, DDS
• Sally Kim, M.D.
• Sara Kim, MD
• Sarah Kim, PHARMD
• Sung Kim, PHARMD, PA-C
• Timothy Yushin Kim
• Unja Kim
• Andrew J. King, M.D.
• Hannah Lea King, DO

• Pediatrics Physician in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.