Sue Soojeong Kim
Individual provider Active NPI Pharmacist · Reedley, CA
NPI 1073094587 · NPPES record last updated Aug 23, 2018
Key facts
- NPI
- 1073094587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 77548 (CA)
- Practice address
- 852 E Manning Ave
Reedley, CA 93654-2232 - Phone
- (559) 643-0367
- NPI assigned
- Aug 23, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77548 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 77548 | CA | Yes |
Addresses
Primary practice location
852 E Manning Ave
Reedley, CA 93654-2232
Mailing address
852 E Manning Ave
Reedley, CA 93654-2232
Phone (559) 643-0367
Other providers in Reedley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.