Active NPI
Maureen Yoojung Kim, PHARMD
- Pharmacist
- Santa Ana, CA
National Provider Identifier
1912510587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 82849
- Practice address
- 1415 N Broadway
Santa Ana, CA 92706-3904 - Phone
- (949) 305-0788
- NPI assigned
- Aug 25, 2020
- 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 | 82849 | CA | Primary |
Addresses
Primary practice location
1415 N Broadway
Santa Ana, CA 92706-3904
Mailing address
1415 N Broadway
Santa Ana, CA 92706-3904
Other practice location 1
300 S Diamond Bar Blvd
Diamond Bar, CA 91765-1607
Phone (909) 861-5551
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 |
|---|---|---|---|
| 82849 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695686400000",
"number": "1912510587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1415 N BROADWAY",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927063904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1415 N BROADWAY",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927063904",
"telephone_number": "949-305-0788"
}
],
"practiceLocations": [
{
"address_1": "300 S Diamond Bar Blvd",
"address_purpose": "LOCATION",
"city": "Diamond Bar",
"state": "CA",
"postal_code": "917651607",
"country_code": "US",
"telephone_number": "909-861-5551",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIM",
"first_name": "MAUREEN",
"middle_name": "YOOJUNG",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-08-25",
"last_updated": "2023-09-26",
"certification_date": "2023-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "82849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.