YEWON KIM
NPI 1366122079
Student in an Organized Health Care Education/Training Program in San Francisco, CA

Q: What is Yewon Kim's NPI number?

The NPI number for Yewon Kim is 1366122079. It was assigned to this individual provider in the NPPES registry on July 19, 2023.

Q: What is Yewon Kim's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Yewon Kim was last updated on July 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since July 19, 2023PECOS Enrolled

3626 BALBOA ST, SAN FRANCISCO, CA 94121(415) 668-5955 Get Directions Write a Review

NPPES record last updated: July 19, 2023. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Yewon Kim NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

YEWON KIM (NPI 1366122079) is an individual student in an organized health care education/training program in San Francisco, California and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1366122079

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameYEWON KIM

Location Address3626 BALBOA STSan Francisco, CA 94121-2604

Mailing Address3626 Balboa StSan Francisco, CA 94121-2604

Phone(415) 668-5955

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateJuly 19, 2023

NPPES CertifiedJuly 19, 2023

✔ NPI 1366122079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

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.

3626 BALBOA ST, San Francisco, CA 94121

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Yewon Kim is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3678041241

PECOS Enrollment IDI20260501003122

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARSHA JOSEPHINE WAINWRIGHT

Counselor (Professional)