Individual provider Active NPI

Jeyeon Kim Mun

  • Pharmacist
  • Bell Gardens, CA
National Provider Identifier
1215257852
Registry record updated Jun 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
55457 Issued in CA
Practice address
6959 Eastern Ave
Bell Gardens, CA 90201-3926
Phone
(323) 562-4613
NPI assigned
Jun 6, 2010
Last updated
Jun 6, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 55457 CA Primary

Addresses

Primary practice location

6959 Eastern Ave
Bell Gardens, CA 90201-3926

Mailing address

5450 Camp St
Cypress, CA 90630-3038
Phone (714) 821-0368

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

LicenseStateTypeSpecialty
55457CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrifty Payless Inc Past Accepting new patients
Thrifty Payless Inc 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": "1275782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275782400000",
    "number": "1215257852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 CAMP ST",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906303038",
            "telephone_number": "714-821-0368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6959 EASTERN AVE",
            "city": "BELL GARDENS",
            "state": "CA",
            "postal_code": "902013926",
            "telephone_number": "323-562-4613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUN",
        "first_name": "JEYEON",
        "middle_name": "KIM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-06",
        "last_updated": "2010-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "55457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bell Gardens, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2010; 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.