Individual provider · Type 1 NPI

Sun Moon Kim, DO

Student in an Organized Health Care Education/Training Program · Philadelphia, PA

NPI number 1669069696 Active · reactivated Apr 16, 2025

Practice location

4190 City Ave
Philadelphia, PA 19131-1626

Call (215) 871-6690 Map

Fax (215) 871-6695

Specialties and licenses

TaxonomyCodeLicense
Pharmacist 183500000X28RI03972600 (NJ)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1669069696

Sun Moon Kim, DO's National Provider Identifier is 1669069696, issued on Dec 23, 2020. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Philadelphia, PA. The record was last updated on Apr 29, 2025.