Healthcare Provider Details

I. General information

NPI: 1114503893
Provider Name (Legal Business Name): SUNG YIM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23845 HOLMAN HWY STE 210
MONTEREY CA
93940-5907
US

IV. Provider business mailing address

100 WILSON RD STE 100
MONTEREY CA
93940-7885
US

V. Phone/Fax

Practice location:
  • Phone: 831-620-0700
  • Fax: 831-886-1538
Mailing address:
  • Phone: 831-242-8394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA195072
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: