Individual provider Active NPI

Minkyung Kim

  • Pharmacist
  • Twentynine Palms, CA
National Provider Identifier
1902126642
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
63225 Issued in CA
Practice address
72253 Twentynine Palms Highway
Twentynine Palms, CA 92277-5911
Phone
(760) 367-3262
NPI assigned
Jun 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 63225 CA Primary

Addresses

Primary practice location

72253 Twentynine Palms Highway
Twentynine Palms, CA 92277-5911

Mailing address

7133 Lennox Ave
Yucca Valley, CA 92284-5911
Phone (760) 550-1014

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

LicenseStateTypeSpecialty
63225CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Whittier Pharmacy Inc Current Accepting new patients
Whittier Pharmacy Inc Current Accepting new patients
Thrifty Payless Inc Past Accepting new patients
Thrifty Payless Inc Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275609600000",
    "number": "1902126642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7133 LENNOX AVE",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922845911",
            "telephone_number": "760-550-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72253 TWENTYNINE PALMS HIGHWAY",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922775911",
            "telephone_number": "760-367-3262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "MINKYUNG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-04",
        "last_updated": "2010-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "63225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twentynine Palms, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.