SOO KYOUNG JOANNA KIM MD
NPI 1093174906
Student in an Organized Health Care Education/Training Program in Sacramento, CA
About Soo Kyoung Joanna Kim Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOO KYOUNG JOANNA KIM MD (NPI 1093174906) is an individual student in an organized health care education/training program in Sacramento, California and active in the NPI registry since February 2016. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Soo Kyoung Joanna Kim Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SACRAMENTO, CA 95817
SACRAMENTO, CA 95817
SACRAMENTO, CA 95817
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Soo Kyoung Kim's NPI number?
The NPI number for Soo Kyoung Kim is 1093174906. It was assigned to this individual provider in the NPPES registry on February 19, 2016.
Where is Soo Kyoung Kim located?
Soo Kyoung Kim practices at 4501 X St # G0140, Sacramento, CA 95817. The listed phone number is (916) 734-8688.
What is Soo Kyoung Kim's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Soo Kyoung Kim enrolled in Medicare?
Yes. Soo Kyoung Kim is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Soo Kyoung Kim was last updated on May 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Soo Kyoung Joanna Kim, MD · NPI 1093174906
Student in an Organized Health Care Education/Training Program provider in Sacramento, California. Individual provider, active in the CMS NPPES registry since February 19, 2016.
## Identity
- **NPI:** 1093174906 (Entity type: Individual)
- **Enumerated:** February 19, 2016
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 4501 X ST # G0140, Sacramento, CA 95817-2229
- **Phone:** (916) 734-8688
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** May 5, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1093174906) · Data from the CMS NPPES public registry.