Active NPI
David Park Kim, PT, DPT
- Physical Therapist
- Los Angeles, CA
National Provider Identifier
1679053383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT294992
- Practice address
- 4610 Valley Blvd # 202
Los Angeles, CA 90032-3857 - Phone
- (818) 783-2396
- Fax
- (818) 783-2467
- NPI assigned
- Aug 21, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT294992 | CA | Primary |
Addresses
Primary practice location
4610 Valley Blvd # 202
Los Angeles, CA 90032-3857
Mailing address
5000 Van Nuys Blvd
Suite 110
Sherman Oaks, CA 91403
Phone (818) 783-2396
Other practice location 1
2123 Garnet Ave Ste B
San Diego, CA 92109-8801
Phone (818) 934-0616
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT294992 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hyena Physical Therapy, Inc. | Current | Accepting new patients | |
| Hyena Physical Therapy la, PC | Current | Accepting new patients |
Locations
4610 Valley Blvd
#202
Los Angeles, CA 90032
Phone (818) 783-2396
2123 Garnet Ave
Ste B
San Diego, CA 92109
Phone (818) 934-0616
Organizations & group practices 2
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.
-
- Physical Therapy Clinic/Center
- Los Angeles, CA
- NPI 1902605447
-
- Physical Therapy Clinic/Center
- San Diego, CA
- NPI 1316716368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780272000000",
"number": "1679053383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 VAN NUYS BLVD",
"address_2": "SUITE 110",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "91403",
"telephone_number": "818-783-2396",
"fax_number": "818-783-2467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4610 VALLEY BLVD # 202",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900323857",
"telephone_number": "818-783-2396",
"fax_number": "818-783-2467"
}
],
"practiceLocations": [
{
"address_1": "2123 Garnet Ave Ste B",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921098801",
"country_code": "US",
"telephone_number": "818-934-0616",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "DAVID",
"middle_name": "PARK",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-21",
"last_updated": "2026-06-01",
"certification_date": "2026-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT294992",
"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 Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.