Individual provider Active NPI

Elaine Nam Yoon Kim, PHARMD

  • Pharmacist
  • San Diego, CA
National Provider Identifier
1043999758
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P10750 Issued in ID
Practice address
3350 La Jolla Village Dr
San Diego, CA 92161-0002
Phone
(858) 552-8585
NPI assigned
Jul 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P10750 ID Primary

Addresses

Primary practice location

3350 La Jolla Village Dr
San Diego, CA 92161-0002

Mailing address

3350 La Jolla Village Dr
San Diego, CA 92161-0002

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

LicenseStateTypeSpecialty
P10750IDMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1043999758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 LA JOLLA VILLAGE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921610002",
            "telephone_number": "858-552-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "ELAINE",
        "middle_name": "NAM YOON",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P10750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.