Active NPI
Sung S. Kim, D.C.
- Chiropractor
- Milpitas, CA
National Provider Identifier
1689771917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC28805
- Practice address
- 615 S Main St
Suite 1
Milpitas, CA 95035-8521 - Phone
- (408) 945-7717
- Fax
- (408) 946-8145
- NPI assigned
- Sep 20, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC28805 | CA | Primary |
Addresses
Primary practice location
615 S Main St
Suite 1
Milpitas, CA 95035-8521
Mailing address
615 S Main St
Suite 1
Milpitas, CA 95035-8521
Phone (408) 945-7717
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC0288050 | Other | CA | PPIN |
| DC28805 | Other | CA | LICENSE |
Other names 1
- Sung James Kim
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 |
|---|---|---|---|
| DC28805 | CA | MD | Chiropractor |
| 28805 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chiropractic Wellness Clinic | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Chiropractor
- Milpitas, CA
- NPI 1861533069
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689771917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 S MAIN ST",
"address_2": "SUITE 1",
"city": "MILPITAS",
"state": "CA",
"postal_code": "950358521",
"telephone_number": "408-945-7717",
"fax_number": "408-946-8145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 S MAIN ST",
"address_2": "SUITE 1",
"city": "MILPITAS",
"state": "CA",
"postal_code": "950358521",
"telephone_number": "408-945-7717",
"fax_number": "408-946-8145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SUNG",
"middle_name": "S.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC28805",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PPIN",
"identifier": "DC0288050",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "DC28805",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SUNG",
"last_name": "KIM",
"middle_name": "JAMES",
"credential": "D.C.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Milpitas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.