Individual
SUNGHOON KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8040 CLEARVISTA PKWY STE 340, INDIANAPOLIS, IN 46256-4673
(317) 621-2660
Mailing address
744 52ND ST, SUITE 4100, OAKLAND, CA 94609-1810
(510) 428-3022
(510) 428-3405
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
01078501A
IN
2086S0120X
Pediatric Surgery Physician
A60075
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A600750
—
CA
01
—
266180957
MEDICARE
IN
05
—
300002154
—
IN
Enumeration date
06/28/2006
Last updated
07/21/2022
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