Active NPI
Soo Jin Kim, PHARM.D
- Pharmacist
- Desert Hot Springs, CA
National Provider Identifier
1811324544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 68667
- Practice address
- 14011 Palm Dr
Desert Hot Springs, CA 92240-6845 - Phone
- (760) 329-3634
- NPI assigned
- Sep 26, 2013
- 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 | 68667 | CA | Primary |
Addresses
Primary practice location
14011 Palm Dr
Desert Hot Springs, CA 92240-6845
Mailing address
2252 W Lincoln Ave Apt A3
Anaheim, CA 92801-6504
Phone (714) 345-8700
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68667 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380153600000",
"number": "1811324544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2252 W LINCOLN AVE APT A3",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928016504",
"telephone_number": "714-345-8700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14011 PALM DR",
"city": "DESERT HOT SPRINGS",
"state": "CA",
"postal_code": "922406845",
"telephone_number": "760-329-3634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SOO JIN",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-26",
"last_updated": "2013-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "68667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Desert Hot Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.