Individual provider Active NPI

David Park Kim, PT, DPT

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1679053383
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT294992 Issued in CA
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

Updated by the provider on Jun 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
PT294992CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hyena Physical Therapy, Inc. CurrentSince Mar 11, 2025 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.

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.

Verify at the official NPI Registry.