Provider Demographics
NPI:1194161091
Name:KIM, ERIC SUN (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:SUN
Last Name:KIM
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 22ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1844
Mailing Address - Country:US
Mailing Address - Phone:615-346-8182
Mailing Address - Fax:615-829-8970
Practice Address - Street 1:2965 WAVERLY DR APT 20
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-2076
Practice Address - Country:US
Practice Address - Phone:615-346-8182
Practice Address - Fax:615-829-8970
Is Sole Proprietor?:No
Enumeration Date:2013-05-17
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH213312084N0400X
MI43015032302084N0400X
TXT24132084N0400X
SCMD849582084N0400X
AZ618852084N0400X
CAA1360002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology