Active NPI
Susan Kim, PHARM D
- Pharmacist
- Davis, CA
National Provider Identifier
1013371210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 41265
- Practice address
- 192 Orchard Park Dr
Apt 287
Davis, CA 95616-5343 - Phone
- (916) 801-7459
- NPI assigned
- Apr 13, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 41265 | CA | Primary |
Addresses
Primary practice location
192 Orchard Park Dr
Apt 287
Davis, CA 95616-5343
Mailing address
192 Orchard Park Dr
Apt 287
Davis, CA 95616-5343
Phone (916) 801-7459
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41265 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460505600000",
"number": "1013371210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "192 ORCHARD PARK DR",
"address_2": "APT 287",
"city": "DAVIS",
"state": "CA",
"postal_code": "956165343",
"telephone_number": "916-801-7459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "192 ORCHARD PARK DR",
"address_2": "APT 287",
"city": "DAVIS",
"state": "CA",
"postal_code": "956165343",
"telephone_number": "916-801-7459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SUSAN",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-13",
"last_updated": "2016-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "41265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.