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ETHAN HYUNSOO KIM
NPI 1669266961
Student in an Organized Health Care Education/Training Program in Loma Linda, CA

Active since April 09, 2025
11234 ANDERSON ST, LOMA LINDA, CA 92350(909) 558-6491 Get Directions Write a Review

NPPES record last updated: April 9, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ethan Hyunsoo Kim NPPES

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

ETHAN HYUNSOO KIM (NPI 1669266961) is an individual student in an organized health care education/training program in Loma Linda, California and active in the NPI registry since April 2025.

NPPES Registry Identity

NPI1669266961
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameETHAN HYUNSOO KIM
Location Address11234 ANDERSON STLoma Linda, CA 92350-1716
Mailing Address11234 Anderson StLoma Linda, CA 92350-1716 · (909) 558-6491
Phone(909) 558-6491
Sole ProprietorNo
Enumeration DateApril 9, 2025
NPPES CertifiedApril 9, 2025
✔ NPI 1669266961 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.
11234 ANDERSON ST, Loma Linda, CA 92350
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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.

DR. THUCAN TIMOTHY BUI DO
Emergency Medicine
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4344
VAHE YACOUBIAN MD, MPH
Orthopaedic Surgery
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (818) 813-4234
AISHA Q EALEY APRN, ACCCNS-N
Clinical Nurse Specialist (Neonatal)
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4248
MR. RANDAL KEITH GILMAN PA
Physician Assistant
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4475
AMR AZZAM MD, PHD
Ophthalmology (Retina Specialist)
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-2182
DARSH THAKRAR M.D.
Radiology (Diagnostic Radiology)
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4000
HAITHAM SIAG MBBCH
Student in an Organized Health Care Education/Training Program
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (914) 267-6104
PRESTON ANDREW SHIRSAT
Student in an Organized Health Care Education/Training Program
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4074

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 Ethan Kim's NPI number?

The NPI number for Ethan Kim is 1669266961. It was assigned to this individual provider in the NPPES registry on April 9, 2025.

Where is Ethan Kim located?

Ethan Kim practices at 11234 Anderson St, Loma Linda, CA 92350. The listed phone number is (909) 558-6491.

What is Ethan Kim's specialty?

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

When was this NPI record last updated?

The NPPES record for Ethan Kim was last updated on April 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.