Active NPI
Sung-Woong Kim, M.D. Inc.
- Anesthesiology Physician
- Garden Grove, CA
National Provider Identifier
1609104504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- A33209
- Legal business name
- SUNG-WOONG KIM, M.D. INC.
- Practice address
- 12828 Harbor Blvd Ste 210
Garden Grove, CA 92840-5834 - Phone
- (714) 741-3200
- NPI assigned
- Dec 3, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sung-Woong Kim, M.D.
- Title
- President
- Phone
- (714) 441-0944
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | A33209 | CA | Primary |
Addresses
Primary practice location
12828 Harbor Blvd Ste 210
Garden Grove, CA 92840-5834
Mailing address
PO Box 5280
Huntington Beach, CA 92615-5280
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A332090 | Medicaid | CA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259798400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1259798400000",
"number": "1609104504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5280",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "926155280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12828 HARBOR BLVD STE 210",
"city": "GARDEN GROVE",
"state": "CA",
"postal_code": "928405834",
"telephone_number": "714-741-3200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUNG-WOONG KIM, M.D. INC.",
"organizational_subpart": "NO",
"enumeration_date": "2009-12-03",
"last_updated": "2009-12-03",
"status": "A",
"authorized_official_last_name": "KIM",
"authorized_official_first_name": "SUNG-WOONG",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "714-441-0944",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": "CA",
"license": "A33209",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A332090",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Garden Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.