Healthcare Provider Details

I. General information

NPI: 1326830118
Provider Name (Legal Business Name): GOLDEN SPRINGS PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21010 GOLDEN SPRINGS DR
DIAMOND BAR CA
91789-3831
US

IV. Provider business mailing address

21010 GOLDEN SPRINGS DR
DIAMOND BAR CA
91789-3831
US

V. Phone/Fax

Practice location:
  • Phone: 909-595-4003
  • Fax:
Mailing address:
  • Phone: 909-595-4003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HYUNG AH KIM
Title or Position: CEO/CFO/DIR.
Credential:
Phone: 949-751-7397