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

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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