Individual
DR. BERNARD SUNGWON KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1245 WILSHIRE BLVD STE 503, LOS ANGELES, CA 90017-4805
(213) 977-4979
(213) 977-0544
Mailing address
1245 WILSHIRE BLVD STE 503, LOS ANGELES, CA 90017-4805
(213) 977-4979
(213) 977-0544
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A108352
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A108352
CA
207RP1001X
Pulmonary Disease Physician
Primary
A108352
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118472323
MEDI-CAL
CA
05
—
2108461
—
MA
01
—
CG467Z
MEDICARE PTAN #
CA
Enumeration date
09/22/2006
Last updated
01/13/2026
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