KT Plaza Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

54469 Issued in CA

Legal business name

KT PLAZA PHARMACY, INC.

Practice address

928 S Western Ave
Ste 110
Los Angeles, CA 90006-1000

Phone

(213) 382-0212

Fax

(213) 382-0812

NPI assigned

Feb 2, 2007

Organization subpart

No

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

Authorized official

Name

Jamie ParkNPI 1215472774

Title

Pharamcist/Pic

Phone

(213) 382-0212

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• KT plaza pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

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

• Jamie Park, PHARMD

  • Pharmacist
  • Los Angeles, CA
  • NPI 1215472774
  NPD Authorized official
• Grace H Kim, PHARMD

  • Pharmacist
  • Los Angeles, CA
  • NPI 1033704184
  NPD (past)
• Hae Young Lim, R.PH

  • Pharmacist
  • Los Angeles, CA
  • NPI 1548243272
  NPD (past)
• June Yoon

  • Pharmacist
  • Los Angeles, CA
  • NPI 1952181372
  NPD (past)

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1811035801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 S WESTERN AVE",
            "address_2": "STE 110",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900061000",
            "telephone_number": "213-382-0212",
            "fax_number": "213-382-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 S WESTERN AVE",
            "address_2": "STE 110",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900061000",
            "telephone_number": "213-382-0212",
            "fax_number": "213-382-0812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KT PLAZA PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "PHARAMCIST/PIC",
        "authorized_official_telephone_number": "213-382-0212"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "54469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2162516",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811035801",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KT plaza pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alla Kryukova, CRNA
• KS MD Group Inc
• KS Medical Group, Inc.
• Pooja Kshirsagar
• KSR Global Logistics LLC
• KT World Acu & Herb Corp
• KT World Wide. Corp
• KTMS, Inc.
• Ktown Medical Group Inc
• Gayane Ktshian, PAC

• Community/Retail Pharmacy in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; 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.