Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Edward Kim

Individual provider Psychiatric/Mental Health Registered Nurse · NPI 1053088799

Edward Kim is a Nurse Practitioner in Torrance, California. Qualified in 2021, 5 years ago. Practices with Jason Kellogg MD Inc, an 18-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

3333 Skypark Dr Ste 220
Torrance, CA 90505-5035
Phone: (855) 501-1004
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95017647 (CA)
Psychiatric/Mental Health Registered Nurse Taxonomy 163WP0808X · Licence 849520 (CA)

Record details

NPI number1053088799
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 29, 2021
Last updated in NPPESMarch 2, 2026
Certification dateMarch 2, 2026
Mailing address3835 N Freeway Blvd Ste 100, Sacramento, CA 95834-1954

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Jason Kellogg Md Inc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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