Individual provider Active NPI

Suyoun Kim

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1730806753
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1300 N Vermont Ave Ste 605
Los Angeles, CA 90027-6088
Phone
(323) 593-7682
NPI assigned
Oct 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CA Primary

Addresses

Primary practice location

1300 N Vermont Ave Ste 605
Los Angeles, CA 90027-6088

Mailing address

1300 N Vermont Ave Ste 605
Los Angeles, CA 90027-6088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250415001600 CA Practitioner - Physician Assistant 3779008537 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Samir a Shah MD Professional Corporation Past Accepting new patients
Citrus Valley Medical Associates, Inc. PastSince Aug 2, 2021 Accepting new patients
Michael R. Gatto MD, Inc. PastSince Aug 1, 2007 Accepting new patients
Employee Medical Consultants PC Past Accepting new patients

Organizations & group practices 5

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": "1666224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1730806753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N VERMONT AVE STE 605",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N VERMONT AVE STE 605",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276088",
            "telephone_number": "323-593-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUYOUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-20",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.