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1255474359

NPI Code Detail

MEDICARE: SUNWOOK KIM MD

MEDICARE: SUNWOOK KIM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	ME77123	FL
2	207V00000X	Obstetrics & Gynecology Physician	24782	NV
3	207V00000X	Obstetrics & Gynecology Physician	14269662-1235	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	592292041	OTHER		TAX ID
2	24782	OTHER	NV	STATE LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255474359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNWOOK KIM MD

Provider Business Mailing Address
First Line	:	PO BOX 27128
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127-0128
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2880 N TENAYA WAY FL 3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0618
Country	:	US
Telephone Number	:	702-255-3547
Fax Number	:	702-307-2204

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	05/26/2026

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Directions to “ SUNWOOK KIM MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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