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General NPI Number Information
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NPI Number | 1225353022
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Entity Type | Individual
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Provider Name | SONYA YOUNG KIM M.D., MBA
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Gender | Female
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Dates
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Enumeration Date | 04/05/2010
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1 DEVONSHIRE BLVD APT 8
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City | SAN CARLOS
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State | CA
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Zip | 94070-1758
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Country | US
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Telephone | 415-314-1005
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Fax | 888-959-8346
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Provider Business Mailing Address
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Address Line | 1 DEVONSHIRE BLVD APT 8
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City | SAN CARLOS
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State | CA
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Zip | 94070-1758
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Country | US
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Telephone | 415-314-1005
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Fax | 888-959-8346
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PT0002X
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Taxonomy Name | Medical Toxicology (Emergency Medicine) Physician
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License Number | A79002
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207PS0010X
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Taxonomy Name | Sports Medicine (Emergency Medicine) Physician
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License Number | A79002
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A79002
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | A79002
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number | A79002
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number | A79002
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License Number State | CA
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Taxonomy #7
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Taxonomy Code | 207PH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Emergency Medicine) Physician
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License Number | A79002
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License Number State | CA
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