Individual provider Active NPI

Minseon Kim

  • Family Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1598566853
Registry record updated Mar 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95034465 Issued in CA
Practice address
2727 W Olympic Blvd Ste 208
Los Angeles, CA 90006-2640
Phone
(213) 908-6434
NPI assigned
Mar 22, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2025

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 95034465 CA Primary

Addresses

Primary practice location

2727 W Olympic Blvd Ste 208
Los Angeles, CA 90006-2640

Mailing address

334 N Serrano Ave
Los Angeles, CA 90004-2712
Phone (213) 776-2365

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
I20260611003302 CA Practitioner - Nurse Practitioner 6103398045 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kdoc IncGroup PAC ID 6002276045, 2 clinicians

Practice addresses (Care Compare)

2727 W Olympic Blvd
Suite 208
Los Angeles, CA 90006-2640
Phone (213) 908-6434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95034465CAMDFamily Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1742601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742601600000",
    "number": "1598566853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 N SERRANO AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900042712",
            "telephone_number": "213-776-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 W OLYMPIC BLVD STE 208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062640",
            "telephone_number": "213-908-6434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MINSEON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-22",
        "last_updated": "2025-03-22",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95034465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.