NPIMap

Individual provider Active NPI

Seung Tack Kim, RPH

  • Pharmacist
  • Honolulu, HI
National Provider Identifier
1194002386
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH-3290 Issued in HI
Practice address
1488 Kapiolani Blvd
Honolulu, HI 96814-3716
Phone
(808) 949-8500
NPI assigned
Nov 16, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH-3290 HI Primary

Addresses

Primary practice location

1488 Kapiolani Blvd
Honolulu, HI 96814-3716

Mailing address

1670 Kalakaua Ave Apt 801
Honolulu, HI 96826-2443
Phone (808) 358-7073

Other names 1

  • Taek Kim Other name

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH-3290HIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Moana Healthcare Current Accepting new patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 3

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": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1194002386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 KALAKAUA AVE APT 801",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968262443",
            "telephone_number": "808-358-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1488 KAPIOLANI BLVD",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968143716",
            "telephone_number": "808-949-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "SEUNG TACK",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-16",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "HI",
            "license": "PH-3290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAEK",
            "last_name": "KIM",
            "credential": "RPH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; 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.