Organization Active NPI

Vein and Wound Center of la

  • Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1629869060
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
VEIN AND WOUND CENTER OF LA
Practice address
3663 W 6TH St Ste 103
Los Angeles, CA 90020-3047
Phone
(213) 654-8346
Fax
(213) 315-6015
NPI assigned
May 15, 2025
Last updated
Aug 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Authorized official

Name
Christopher Sung-Bo KimNPI 1588155477
Title
Owner
Phone
(213) 654-8346

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

3663 W 6TH St Ste 103
Los Angeles, CA 90020-3047

Mailing address

3663 W 6TH St Ste 103
Los Angeles, CA 90020-3047
Phone (213) 654-8346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250529002085 CA Part B Supplier - Clinic/Group Practice 6608395942 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787011200000",
    "number": "1629869060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3663 W 6TH ST STE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203047",
            "telephone_number": "213-654-8346",
            "fax_number": "213-315-6015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3663 W 6TH ST STE 103",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203047",
            "telephone_number": "213-654-8346",
            "fax_number": "213-315-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEIN AND WOUND CENTER OF LA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-15",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "SUNG-BO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-654-8346"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.