Organization Active NPI

SJ Pharmacy Investment Inc.

Doing business as J Pharmacy

  • Community/Retail Pharmacy
  • Los Angeles, CA
National Provider Identifier
1376057612
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SJ PHARMACY INVESTMENT INC.
Doing business as
J Pharmacy
Practice address
356 S Western Ave Ste 104-105
Los Angeles, CA 90020-3814
Phone
(213) 908-6424
Fax
(213) 908-6310
NPI assigned
Nov 23, 2017
Last updated
Dec 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Authorized official

Name
Karen Hyun Kim, PHARMDNPI 1467966705
Title
Ceo
Phone
(323) 836-3686

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

356 S Western Ave Ste 104-105
Los Angeles, CA 90020-3814

Mailing address

356 S Western Ave Ste 104-105
Los Angeles, CA 90020-3814
Phone (213) 908-6424

Other identifiers 1

IdentifierTypeStateIssuer
1376057612MedicaidCA

Other names 1

  • J Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180402000669 CA Part B Supplier - Mass Immunization (Roster Biller Only) 9739441734 Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

1825 W Avenue J
Ste 115
Lancaster, CA 93534
Phone (661) 723-8001

356 S Western Ave
Ste 104
Los Angeles, CA 90020
Phone (213) 908-6424

356 S Western Ave
Ste 104105
Los Angeles, CA 90020
Phone (213) 908-6424

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1511395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609200000000",
    "number": "1376057612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 S WESTERN AVE STE 104-105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203814",
            "telephone_number": "213-908-6424",
            "fax_number": "213-908-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 S WESTERN AVE STE 104-105",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203814",
            "telephone_number": "213-908-6424",
            "fax_number": "213-908-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SJ PHARMACY INVESTMENT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-23",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "HYUN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-836-3686",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376057612",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "J Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.