Active NPI
Min Jeong Kim
- Pharmacist
- Mountain View, CA
National Provider Identifier
1659909901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH80400
- Practice address
- 1905 W El Camino Real
Mountain View, CA 94040-2216 - Phone
- (650) 967-3531
- NPI assigned
- Mar 31, 2020
- 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 | RPH80400 | CA | Primary |
Addresses
Primary practice location
1905 W El Camino Real
Mountain View, CA 94040-2216
Mailing address
881 E El Camino Real Apt 422
Mountain View, CA 94040-2840
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 |
|---|---|---|---|
| RPH80400 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
1905 W El Camino Real
Mountain View, CA 94040
Phone (650) 967-3531
Organizations & group practices 2
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": "1585612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585612800000",
"number": "1659909901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "881 E EL CAMINO REAL APT 422",
"city": "MOUNTAIN VIEW",
"state": "CA",
"postal_code": "940402840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1905 W EL CAMINO REAL",
"city": "MOUNTAIN VIEW",
"state": "CA",
"postal_code": "940402216",
"telephone_number": "650-967-3531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "MIN JEONG",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-31",
"last_updated": "2020-03-31",
"certification_date": "2020-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "RPH80400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain View, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.