Active NPI
Hae Young Suh
- Pharmacist
- Victorville, CA
National Provider Identifier
1639686389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 73804
- Practice address
- 11896 Amargosa Rd
Victorville, CA 92392-8133 - Phone
- (760) 951-5188
- NPI assigned
- Jan 3, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 73804 | CA | Primary |
Addresses
Primary practice location
11896 Amargosa Rd
Victorville, CA 92392-8133
Mailing address
11896 Amargosa Rd
Victorville, CA 92392-8133
Phone (760) 951-5188
Other names 1
- Hae Young Kim
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 |
|---|---|---|---|
| 73804 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514937600000",
"number": "1639686389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11896 AMARGOSA RD",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923928133",
"telephone_number": "760-951-5188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11896 AMARGOSA RD",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923928133",
"telephone_number": "760-951-5188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUH",
"first_name": "HAE",
"middle_name": "YOUNG",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-03",
"last_updated": "2018-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "73804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "HAE",
"last_name": "KIM",
"middle_name": "YOUNG",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.