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NPI Code Detail

MEDICARE: DR. KIM DUONG PHARMD

MEDICARE: DR. KIM DUONG PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist60418CA

General Provider Information

NPI Number : 1578845384
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIM DUONG PHARMD
Provider Business Mailing Address
First Line : 1700 E VISTA CHINO
Second Line :
City : PALM SPRINGS
State : CA
Zip : 92262-3511
Country : US
Telephone Number : 760-864-1516
Fax Number : 760-864-1568
Provider Business Practice Location Address
First Line : 1700 E VISTA CHINO
Second Line :
City : PALM SPRINGS
State : CA
Zip : 92262-3511
Country : US
Telephone Number : 760-864-1516
Fax Number : 760-864-1568
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2011
Last Update Date : 09/20/2011

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