Individual provider Active NPI

Joanna Jongae Kim, PHARM.D

  • Pharmacist
  • Long Beach, CA
National Provider Identifier
1366058794
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
82034 Issued in CA
Practice address
1750 Pacific Ave # a
Long Beach, CA 90813-1715
Phone
(562) 599-5292
Fax
(562) 599-1893
NPI assigned
Sep 21, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 82034 CA Primary

Addresses

Primary practice location

1750 Pacific Ave # a
Long Beach, CA 90813-1715

Mailing address

1750 Pacific Ave # a
Long Beach, CA 90813-1715
Phone (562) 599-5292

Other names 1

  • Dr. Joanna J Kim Professional 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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
82034CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Joanna J Kim Pharmacist Inc CurrentSince Nov 17, 2024 Accepting new patients
Joanna J Kim Pharmacist Inc Pharmacy CurrentSince Oct 8, 2023 Accepting new patients

Locations

1750 Pacific Ave
#A
Long Beach, CA 90813
Phone (562) 599-5292

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": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1366058794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 PACIFIC AVE # A",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908131715",
            "telephone_number": "562-599-5292",
            "fax_number": "562-599-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 PACIFIC AVE # A",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908131715",
            "telephone_number": "562-599-5292",
            "fax_number": "562-599-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "JOANNA",
        "middle_name": "JONGAE",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "82034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANNA",
            "last_name": "KIM",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "PHARM.D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.