Healthcare Provider Details

I. General information

NPI: 1043779986
Provider Name (Legal Business Name): UNJA KIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 CAMPUS POINT DR
LA JOLLA CA
92037-1300
US

IV. Provider business mailing address

FILE # 57326
LOS ANGELES CA
90074-0001
US

V. Phone/Fax

Practice location:
  • Phone: 800-926-8273
  • Fax:
Mailing address:
  • Phone: 800-926-8273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95009688
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WX0002X
TaxonomyHigh-Risk Obstetric Registered Nurse
License Number691016
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number235962
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number81336
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: