Active NPI
Elizabeth Kim
- Pharmacist
- Fullerton, CA
National Provider Identifier
1417321464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 50403
- Practice address
- 1823 W Orangethorpe Ave
Fullerton, CA 92833-4405 - Phone
- (714) 871-3040
- NPI assigned
- Nov 13, 2015
- 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 | 50403 | CA | Primary |
Addresses
Primary practice location
1823 W Orangethorpe Ave
Fullerton, CA 92833-4405
Mailing address
13846 Monterey LN
La Mirada, CA 90638-6591
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 |
|---|---|---|---|
| 50403 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 1
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": "1447372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447372800000",
"number": "1417321464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13846 MONTEREY LN",
"city": "LA MIRADA",
"state": "CA",
"postal_code": "906386591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1823 W ORANGETHORPE AVE",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928334405",
"telephone_number": "714-871-3040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "ELIZABETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-11-13",
"last_updated": "2015-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "50403",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.