Healthcare Provider Details

I. General information

NPI: 1114836913
Provider Name (Legal Business Name): SUNAH EUNICE KIM DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3277 GRAND AVE STE C
CHINO HILLS CA
91709-1490
US

IV. Provider business mailing address

5575 VERONESE DR
CHINO HILLS CA
91709-4698
US

V. Phone/Fax

Practice location:
  • Phone: 909-497-7170
  • Fax:
Mailing address:
  • Phone: 213-220-5669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF09260256
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: