Active NPI
Leean Kim
- Community/Retail Pharmacy
- La Habra, CA
National Provider Identifier
1669077871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 80330
- Practice address
- 777 S Harbor Blvd
La Habra, CA 90631-6882 - Phone
- (800) 753-0596
- NPI assigned
- Dec 3, 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 |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 80330 | CA | Primary |
Addresses
Primary practice location
777 S Harbor Blvd
La Habra, CA 90631-6882
Mailing address
777 S Harbor Blvd
La Habra, CA 90631-6882
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 |
|---|---|---|---|
| 80330 | CA | MD | Community/Retail Pharmacy |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606953600000",
"number": "1669077871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 S HARBOR BLVD",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906316882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 S HARBOR BLVD",
"city": "LA HABRA",
"state": "CA",
"postal_code": "906316882",
"telephone_number": "800-753-0596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "LEEAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-03",
"last_updated": "2020-12-03",
"certification_date": "2020-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CA",
"license": "80330",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Habra, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.