Active NPI
Han NA Kim
- Pharmacist
- Rancho Mirage, CA
National Provider Identifier
1124645122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 80895
- Practice address
- 42520 Bob Hope Dr
Rancho Mirage, CA 92270-4471 - Phone
- (760) 568-5651
- NPI assigned
- Jun 25, 2020
- Last updated
- Jun 25, 2020
- Sex
- Female
- Sole proprietor
- No
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 | 80895 | CA | Primary |
Addresses
Primary practice location
42520 Bob Hope Dr
Rancho Mirage, CA 92270-4471
Mailing address
73373 Country Club Dr Apt 2015
Palm Desert, CA 92260-8633
Phone (310) 972-0051
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 80895 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Longs Drug Stores California LLC | Past | Accepting new patients | |
| Longs Drug Store California LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593043200000",
"number": "1124645122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "73373 COUNTRY CLUB DR APT 2015",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922608633",
"telephone_number": "310-972-0051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42520 BOB HOPE DR",
"city": "RANCHO MIRAGE",
"state": "CA",
"postal_code": "922704471",
"telephone_number": "760-568-5651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "HAN",
"middle_name": "NA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-25",
"last_updated": "2020-06-25",
"certification_date": "2020-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "80895",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Mirage, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.