Active NPI
Miyoung Kim, PHARMD
- Pharmacist
- La Puente, CA
National Provider Identifier
1215518634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 84015
- Practice address
- 934 N Hacienda Blvd
La Puente, CA 91744-2845 - Phone
- (626) 934-1926
- NPI assigned
- Apr 16, 2021
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 20552 | AL | |
| Pharmacist | 183500000X | 031234 | GA | |
| Pharmacist | 183500000X | 84015 | CA | Primary |
Addresses
Primary practice location
934 N Hacienda Blvd
La Puente, CA 91744-2845
Mailing address
934 N Hacienda Blvd
La Puente, CA 91744-2845
Phone (626) 934-1926
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84015 | CA | MD | Marriage & Family Therapist |
| 20552 | AL | MD | Family Medicine Physician |
| 031234 | GA | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618531200000",
"number": "1215518634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "934 N HACIENDA BLVD",
"city": "LA PUENTE",
"state": "CA",
"postal_code": "917442845",
"telephone_number": "626-934-1926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "934 N HACIENDA BLVD",
"city": "LA PUENTE",
"state": "CA",
"postal_code": "917442845",
"telephone_number": "626-934-1926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MIYOUNG",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-16",
"last_updated": "2021-04-16",
"certification_date": "2021-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "20552",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "031234",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "84015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Puente, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.