Active NPI
Soon Young Yim
Doing business as Eden Pharmacy
- Community/Retail Pharmacy
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHY46931
- Legal business name
- SOON YOUNG YIM
- Doing business as
- Eden Pharmacy
- Practice address
- 2681 W Olympic Blvd
Ste 102
Los Angeles, CA 90006-2810 - Phone
- (213) 381-7705
- Fax
- (213) 381-7706
- NPI assigned
- May 11, 2006
- Last updated
- Jun 10, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Soon Young Yim, RPH
- Title
- Owner
- Phone
- (213) 381-7705
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHY46931 | CA | Primary |
Addresses
Primary practice location
2681 W Olympic Blvd
Ste 102
Los Angeles, CA 90006-2810
Mailing address
2681 W Olympic Blvd
Ste 102
Los Angeles, CA 90006-2810
Other names 1
- Eden Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100611000360 | CA | Part B Supplier - Mass Immunization (Roster Biller Only) | 7618007055 | Practice locations: Los Angeles, CA |
National Provider Directory
National Provider DirectoryLocations
2681 W Olympic Blvd
Ste 10
Los Angeles, CA 90006
2681 W Olympic Blvd
Ste 102
Los Angeles, CA 90006
Phone (213) 381-7705
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Los Angeles, CA
- NPI 1497027486
-
- Pharmacist
- Los Angeles, CA
- NPI 1609463660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1276128000000",
"number": "1154371268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2681 W OLYMPIC BLVD",
"address_2": "STE 102",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900062810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2681 W OLYMPIC BLVD",
"address_2": "STE 102",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900062810",
"telephone_number": "213-381-7705",
"fax_number": "213-381-7706"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOON YOUNG YIM",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-11",
"last_updated": "2010-06-10",
"status": "A",
"authorized_official_last_name": "YIM",
"authorized_official_first_name": "SOON YOUNG",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "213-381-7705",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CA",
"license": "PHY46931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Eden Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.