Individual provider Active NPI

Casey C Kim, PHARM.D.

  • Pharmacist
  • Brea, CA
National Provider Identifier
1568706356
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
48074 Issued in CA
Practice address
2667 E Stearns St
Brea, CA 92821-4757
Phone
(562) 706-0072
NPI assigned
Nov 16, 2012
Last updated
Nov 16, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 48074 CA Primary

Addresses

Primary practice location

2667 E Stearns St
Brea, CA 92821-4757

Mailing address

2667 E Stearns St
Brea, CA 92821-4757
Phone (562) 706-0072

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
48074CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1568706356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2667 E STEARNS ST",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928214757",
            "telephone_number": "562-706-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2667 E STEARNS ST",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928214757",
            "telephone_number": "562-706-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "CASEY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-16",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "48074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; 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.