Active NPI
Sue J Kim, PHARM.D.
- Pharmacist
- South San Francisco, CA
National Provider Identifier
1891935672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 62695
- Practice address
- 399 El Camino Real
South San Francisco, CA 94080-5923 - Phone
- (650) 583-8685
- Fax
- (650) 583-9156
- NPI assigned
- Mar 6, 2009
- Last updated
- Oct 10, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 20933 | IA | |
| Pharmacist | 183500000X | 62695 | CA | Primary |
Addresses
Primary practice location
399 El Camino Real
South San Francisco, CA 94080-5923
Mailing address
399 El Camino Real
South San Francisco, CA 94080-5923
Phone (650) 583-8685
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 |
|---|---|---|---|
| 20933 | IA | MD | Pharmacist |
| 62695 | CA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318204800000",
"number": "1891935672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "399 EL CAMINO REAL",
"city": "SOUTH SAN FRANCISCO",
"state": "CA",
"postal_code": "940805923",
"telephone_number": "650-583-8685",
"fax_number": "650-583-9156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "399 EL CAMINO REAL",
"city": "SOUTH SAN FRANCISCO",
"state": "CA",
"postal_code": "940805923",
"telephone_number": "650-583-8685",
"fax_number": "650-583-9156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "SUE",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-06",
"last_updated": "2011-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "20933",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "62695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.