Active NPI
Charles C Kim, PHARMD
- Pharmacist
- Valencia, CA
National Provider Identifier
1326299801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 50017
- Practice address
- 23850 Copperhill Dr
Valencia, CA 91354-1701 - Phone
- (661) 775-3944
- NPI assigned
- Oct 2, 2008
- Last updated
- Mar 13, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 50017 | CA | Primary |
Addresses
Primary practice location
23850 Copperhill Dr
Valencia, CA 91354-1701
Mailing address
28973 Buena Vista CT
Valencia, CA 91354-3020
Phone (661) 513-3150
Other practice location 1
25050 Peachland Ave
Newhall, CA 91321-2523
Phone (661) 255-7910
Other practice location 2
27641 Bouquet Canyon Rd
Saugus, CA 91350-1793
Phone (661) 296-9269
Other practice location 3
7316 Compton Ave
Los Angeles, CA 90001-2532
Phone (323) 586-9828
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 |
|---|---|---|---|
| 50017 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lido Pharmacy LLC | Past | Accepting new patients | |
| Bravo Pharmacy LLC | 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.
-
dba Newport Lido Pharmacy
- Community/Retail Pharmacy
- Newport Beach, CA
- NPI 1164550885
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552435200000",
"number": "1326299801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28973 BUENA VISTA CT",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913543020",
"telephone_number": "661-513-3150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23850 COPPERHILL DR",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913541701",
"telephone_number": "661-775-3944"
}
],
"practiceLocations": [
{
"address_1": "25050 Peachland Ave",
"address_purpose": "LOCATION",
"city": "Newhall",
"state": "CA",
"postal_code": "913212523",
"country_code": "US",
"telephone_number": "661-255-7910",
"fax_number": "661-255-7987",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "27641 Bouquet Canyon Rd",
"address_purpose": "LOCATION",
"city": "Saugus",
"state": "CA",
"postal_code": "913501793",
"country_code": "US",
"telephone_number": "661-296-9269",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7316 Compton Ave",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900012532",
"country_code": "US",
"telephone_number": "323-586-9828",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "CHARLES",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-02",
"last_updated": "2019-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "50017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valencia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.