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Elizabeth Sun Kim

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

100 Medical Plaza Suite 690, Los Angeles, CA 90095-7368

PECOS Enrollment

This provider is enrolled in PECOS as ELIZABETH KIM.

Based on the most recent information from CMS, provider Elizabeth Sun Kim is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:00 PM.

Profile Details

Provider ID
1891206538
Provider Type
Individual
Full Name
Kim, Elizabeth Sun
Credential
NP

Gender
Female
Sole Proprietor
No
Enumeration Date
10/20/2017
Last Updated
12/1/2023

Contact Information

Practice Location

100 Medical Plaza Suite 690, Los Angeles, CA 90095-7368

(310) 206-2235

Unlisted Fax

Mailing Location

5767 W Century Blvd Ste 400, Los Angeles, CA 90045-5631

(310) 301-8707

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LA2100X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 95006982 California

Elizabeth Sun Kim

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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