# PEDIATRIC SURGICAL ASSOCIATES OF THE EAST BAY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619932209
- **Authorized official:** SUNGHOON KIM M.D. (MANAGING PARTNER)
- **Authorized official phone:** (510) 428-3017

## Contact information

- **Practice address:** 744 52ND ST, SUITE 4100, OAKLAND, CA 94609-1810
- **Practice address phone:** (510) 428-3017
- **Practice address fax:** (510) 428-3405
- **Mailing address:** 5528 PACHECO BLVD, SUITE A, PACHECO, CA 94553-5154
- **Mailing address phone:** (925) 363-8170
- **Mailing address fax:** (925) 363-8178

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0120X | Pediatric Surgery Physician | — | CA | Yes |

## Other

- **Enumeration date:** 04/18/2006
- **Last updated:** 05/19/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR0086800 | — | CA |