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NPI Code Detail

MEDICARE: CHONG KIM

MEDICARE:   CHONG  KIM
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
1183500000XPharmacist60714CA

General Provider Information

NPI Number : 1669895850
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHONG KIM
Provider Business Mailing Address
First Line : 670 S WESTERN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90005-3024
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 670 S WESTERN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90005-3024
Country : US
Telephone Number : 213-383-6207
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2014
Last Update Date : 01/24/2014

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Directions to “ CHONG KIM ” Practice Location

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