Moon Ju Kim, N.P.

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

NP8434 Issued in CA

Practice address

1058 S Vermont Ave
Los Angeles, CA 90006-2721

Phone

(213) 380-8833

Fax

(213) 368-6047

NPI assigned

May 9, 2007

Last updated

May 8, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Koryo Health Foundation

  • Primary Care Clinic/Center
  • Los Angeles, CA
  • NPI 1952460156
  Authorized official Same address or phone
• Koryo Health Foundaton

  dba Koryo Health Foundation

  • Non-Surgical Family Planning Clinic/Center
  • Los Angeles, CA
  • NPI 1497933691
  Authorized official Same address or phone

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1679787766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1058 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062721",
            "telephone_number": "213-380-8833",
            "fax_number": "213-368-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1058 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900062721",
            "telephone_number": "213-380-8833",
            "fax_number": "213-368-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MOON",
        "middle_name": "JU",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "NP8434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0084340",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Minyoung Marilyn Kim
• Mira Joan Kim, MSW
• Miye Kim
• Monica Eunjean Kim, M.D.
• Moon Kim
• Moonsuk Kim, PA
• Myeong Cheol Kim, M.D.
• Myong Kim, LCSW
• Myungju Kim
• NA Eun Kim, MD

• Women's Health Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Women's Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; 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.