Provider Type Icon

SOO KYOUNG JOANNA KIM MD NPI 1093174906


NPI Information

NPI: 1093174906
Provider Name: SOO KYOUNG JOANNA KIM, MD
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual

PECOS Registration: Yes

Address:
4501 X ST # G0140
SACRAMENTO, CA
ZIP 95817
Phone: (916) 734-8688
Get Directions

Soo Kyoung Joanna Kim, MD is a student in an organized health care education training program in Sacramento, CA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Soo Kyoung Joanna Kim, MD NPI is 1093174906. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4501 X ST # G0140
SACRAMENTO, CA
ZIP 95817-229
Phone: (916) 734-8688

The NPI 1093174906 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/19/2016 and was last updated on 5/5/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1227900000XRespiratory Therapist, RegisteredLR60505221WASHINGTONNo
2390200000XStudent in an Organized Health Care Education/Training ProgramCALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.