Kyong Kim, PHARMD
Individual provider Active NPI Pharmacist · Maywood, CA
NPI 1811218944 · NPPES record last updated Jun 11, 2010
Key facts
- NPI
- 1811218944
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 55113 (CA)
- Practice address
- 4410 Slauson Ave
Maywood, CA 90270-2932 - Phone
- (323) 771-9422
- NPI assigned
- Jun 11, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55113 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrifty Payless Inc | Past | Accepting new patients | |
| Thrifty Payless Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 55113 | CA | Yes |
Addresses
Primary practice location
4410 Slauson Ave
Maywood, CA 90270-2932
Mailing address
345 S New Hampshire Ave
#108
Los Angeles, CA 90020-1849
Phone (213) 700-1608
Other providers in Maywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 11, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.