Provider Demographics
NPI:1376859876
Name:KYM, SARAH ELYSSE (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELYSSE
Last Name:KYM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUNG
Other - Middle Name:EUN
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 36900
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-6900
Mailing Address - Country:US
Mailing Address - Phone:702-240-1215
Mailing Address - Fax:702-243-7531
Practice Address - Street 1:2950 S MARYLAND PKWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2204
Practice Address - Country:US
Practice Address - Phone:702-732-6000
Practice Address - Fax:702-732-6071
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2085R0202X2085R0202X
NV158602085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology