Active NPI
Yonghyun Kim
- Pharmacist
- Colton, CA
National Provider Identifier
1316487986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 76179
- Practice address
- 1040 S Mount Vernon Ave Ste E
Colton, CA 92324-4228 - Phone
- (909) 222-4884
- NPI assigned
- Mar 2, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 | 76179 | CA | Primary |
Addresses
Primary practice location
1040 S Mount Vernon Ave Ste E
Colton, CA 92324-4228
Mailing address
1040 S Mount Vernon Ave Ste E
Colton, CA 92324-4228
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 |
|---|---|---|---|
| 76179 | CA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brotherhood Pharmacy Inc | Current | Accepting new patients | |
| Brotherhood Pharmacy Inc | Current | Accepting new patients |
Locations
1040 S Mount Vernon Ave
Ste E
Colton, CA 92324
Phone (909) 222-4884
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.
-
dba Brotherhood Pharmacy
- Community/Retail Pharmacy
- Colton, CA
- NPI 1487296364
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572912000000",
"number": "1316487986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 S MOUNT VERNON AVE STE E",
"city": "COLTON",
"state": "CA",
"postal_code": "923244228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 S MOUNT VERNON AVE STE E",
"city": "COLTON",
"state": "CA",
"postal_code": "923244228",
"telephone_number": "909-222-4884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "YONGHYUN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-02",
"last_updated": "2019-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "76179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.