1. Home
  2. Directory
  3. California
  4. Artesia
  5. Pediatrics
  6. NPI Profile

DR. KUNGSOO KIM M.D.
NPI 1467415455
Pediatrics - Adolescent Medicine in Artesia, CA

Active since April 10, 2006CLIA 05D0964833 · Waiver
18102 PIONEER BLVD, #201, ARTESIA, CA 90701(562) 865-8537(562) 860-0952 Get Directions Write a Review

NPPES record last updated: June 2, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Kungsoo Kim M.d. NPPES

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

DR. KUNGSOO KIM M.D. (NPI 1467415455) is an individual adolescent medicine provider in Artesia, California, licensed in California (A47842) and active in the NPI registry since April 2006. He holds a CLIA Waiver certificate valid through September 2, 2027.

NPPES Registry Identity

NPI1467415455
Entity TypeIndividualMale
Primary Taxonomy2080A0000X
Provider Legal NameDR. KUNGSOO KIMCredential: M.D.
Location Address18102 PIONEER BLVD, #201Artesia, CA 90701-3953
Mailing Address18102 Pioneer Blvd, #201Artesia, CA 90701-3953 · (562) 865-8537 · Fax (562) 860-0952
Phone(562) 865-8537
Fax(562) 860-0952
Sole ProprietorYes
Enumeration DateApril 10, 2006
Last NPPES UpdateJune 2, 2011
✔ NPI 1467415455 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
License✔ Licensed in CA · A47842
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
18102 PIONEER BLVD, Artesia, CA 90701
Open in Google Maps ↗

Other Identifiers 1

Medicaid00A478420CA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0964833

Kungsoo Kim MD · Artesia, CA
Active · expires Sep 2, 2027
CLIA Number05D0964833
Laboratory TypePhysician Office
Certificate Effective DateSeptember 3, 2025
Certificate Expiration DateSeptember 2, 2027
Laboratory DirectorKungsoo K. Kim MD
Laboratory Phone(562) 865-8537
Laboratory LocationKungsoo Kim MD18102 Pioneer Blvd #201, Artesia, CA 90701
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

UKJAE JUNG DDS INCORPORATED
Dentist (General Practice)
18102 PIONEER BLVD
ARTESIA, CA 90701
Los Angeles County (562) 865-9100
DENO D KANG M D INC
Internal Medicine (Nephrology)
18102 PIONEER BLVD, SUITE 204
ARTESIA, CA 90701
Los Angeles County (562) 402-9801
MR. DENO D KANG MD
Internal Medicine (Nephrology)
18102 PIONEER BLVD, NUMBER 204
ARTESIA, CA 90701
Los Angeles County (562) 402-9801
JACK HAVRAN
Chiropractor
18102 PIONEER BLVD, SUITE 104
ARTESIA, CA 90701
Los Angeles County (562) 924-1695
STEPHEN J. CURRY A PROFESSIONAL CHIROPRACTIC CORP.
Chiropractor
18102 PIONEER BLVD, SUITE 104
ARTESIA, CA 90701
Los Angeles County (562) 924-1695
DR. RHODA D RICAFRANCA-EVANS D.C.
Chiropractor
18102 PIONEER BLVD, SUITE 104
ARTESIA, CA 90701
Los Angeles County (562) 924-1695

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 Kungsoo Kim's NPI number?

The NPI number for Kungsoo Kim is 1467415455. It was assigned to this individual provider in the NPPES registry on April 10, 2006.

Where is Kungsoo Kim located?

Kungsoo Kim practices at 18102 Pioneer Blvd #201, Artesia, CA 90701. The listed phone number is (562) 865-8537.

What is Kungsoo Kim's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Does Kungsoo Kim hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0964833) is associated with this NPI, valid through September 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kungsoo Kim was last updated on June 2, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.