Organization Active NPI

Minah Kim

Doing business as Cal Oaks Pharmacy

  • Community/Retail Pharmacy
  • Pasadena, CA
National Provider Identifier
1649293697
Registry record updated Feb 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY47497 Issued in CA
Legal business name
MINAH KIM
Doing business as
Cal Oaks Pharmacy
Practice address
55 E California Blvd
Suite 103
Pasadena, CA 91105-3954
Phone
(626) 795-5956
Fax
(626) 795-4998
NPI assigned
Jul 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2011

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

Authorized official

Name
Dr. Minah Kim, PHARM. D.NPI 1073744264
Title
Owner
Phone
(626) 795-5956

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 PHY47497 CA Primary

Addresses

Primary practice location

55 E California Blvd
Suite 103
Pasadena, CA 91105-3954

Mailing address

55 E California Blvd
Suite 103
Pasadena, CA 91105-3954
Phone (626) 795-5956

Other names 1

  • CAL OAKS PHARMACY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120224000622 CA Part B Supplier - Mass Immunization (Roster Biller Only) 7911100342 Practice locations: Pasadena, CA

National Provider Directory

National Provider Directory

Locations

55 E California Blvd
Ste 103
Pasadena, CA 91105
Phone (626) 795-5956

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297814400000",
    "number": "1649293697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E CALIFORNIA BLVD",
            "address_2": "SUITE 103",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053954",
            "telephone_number": "626-795-5956",
            "fax_number": "626-795-4998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E CALIFORNIA BLVD",
            "address_2": "SUITE 103",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053954",
            "telephone_number": "626-795-5956",
            "fax_number": "626-795-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINAH KIM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2011-02-16",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MINAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-795-5956",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM. D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY47497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAL OAKS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; 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.