Healthcare Provider Details

I. General information

NPI: 1073775748
Provider Name (Legal Business Name): SOOHYUN KIM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8530 W SUNSET RD STE 345
LAS VEGAS NV
89113-2247
US

IV. Provider business mailing address

8530 W SUNSET RD STE 345
LAS VEGAS NV
89113-2247
US

V. Phone/Fax

Practice location:
  • Phone: 702-670-0912
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number28038
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: