Sung Juan Kim

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

306839 Issued in CA

Practice address

1995 Zinfandel Dr Ste 205
Rancho Cordova, CA 95670-2862

Phone

(916) 635-9199

NPI assigned

Sep 16, 2024

Last updated

Sep 16, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• California Luna Care Physical Therapy PC

  • Physical Therapist
  • Los Gatos, CA
  • NPI 1689162166
  NPD

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1972330900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16303 RANMORE DR",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917454953",
            "telephone_number": "626-872-9493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 ZINFANDEL DR STE 205",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956702862",
            "telephone_number": "916-635-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SUNG JUAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "306839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hossein Khanzadeh, PHARM.D.
• Thomas P. Kidwell, MD
• Rachel R Kiene, LM, CPM
• Susan Kim-Almer, BS
• Eric Sumin Kim
• Yon Su Kim, O.D.
• Kimberly's Residential Care HM
• Kimberly's Residential Care Home
• Edith Nyambura Kimotho
• Kirandeep Pinky Dental Corporation (Anatolia Dental Group)

• Physical Therapist in Rancho Cordova, CA
• Providers in Rancho Cordova, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.