Ernest Sung Kim
Family Doctor - Sports Medicine
4094 4th Ave
San Diego
, California 92103-2143
Ernest Sung Kim
Family Doctor - Sports Medicine
4094 4th Ave
San Diego
, California 92103-2143
(619) 269-0674
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About
Features
Specialties
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Ernest Sung Kim
- 823 Gateway Center Way
- San Diego, CA
- Zip : 92102-4541
- Fax : (619) 269-0674
- Phone : (619) 515-2300
Second Address
- Ernest Sung Kim
- 4094 4th Ave
- San Diego, CA
- Zip : 92103-2143
- Fax : (619) 501-9645
- Phone : (619) 515-2545
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QS0010X | Family Doctor - Sports Medicine | A156221 | CA |
National Provider Identifier
| NPI | 1124414925 |
|---|---|
| Provider Name | Ernest Sung Kim |
| First Address | San Diego, CA 92102-4541 |
| Second Address | San Diego, CA 92103-2143 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/04/2015 |
| Last Update Date | 18/05/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.