Healthcare Provider Details

I. General information

NPI: 1568031011
Provider Name (Legal Business Name): SUNG WHEE KIM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2021
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23700 CAMINO DEL SOL
TORRANCE CA
90505-5017
US

IV. Provider business mailing address

PO BOX 4570
PALOS VERDES PENINSULA CA
90274-9607
US

V. Phone/Fax

Practice location:
  • Phone: 310-530-1151
  • Fax:
Mailing address:
  • Phone: 424-400-7748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number38099
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA201846
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: