Healthcare Provider Details

I. General information

NPI: 1093670903
Provider Name (Legal Business Name): SUNG YEON KIM PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2025
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 KING AVE
CORCORAN CA
93212-9611
US

IV. Provider business mailing address

2446 S LINWOOD ST
VISALIA CA
93277-5758
US

V. Phone/Fax

Practice location:
  • Phone: 559-992-8800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number90924
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: