Active NPI
Sandy Song Kim, PHARM.D.
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1366704231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 65875
- Practice address
- 1985 Zonal Ave
PSC B-15
Los Angeles, CA 90089-1904 - Phone
- (818) 903-5422
- NPI assigned
- Jun 15, 2012
- Sex
- Female
- 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 | 65875 | CA | Primary |
Addresses
Primary practice location
1985 Zonal Ave
PSC B-15
Los Angeles, CA 90089-1904
Mailing address
27107 Tourney Avenue
Los Angeles, CA 90089-1904
Phone (661) 222-2134
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557100800000",
"number": "1366704231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27107 TOURNEY AVENUE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900891904",
"telephone_number": "661-222-2134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1985 ZONAL AVE",
"address_2": "PSC B-15",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900891904",
"telephone_number": "818-903-5422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SANDY",
"middle_name": "SONG",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-15",
"last_updated": "2019-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "65875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.