Healthcare Provider Details

I. General information

NPI: 1619325867
Provider Name (Legal Business Name): SARAH KIM PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2016
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10666 N TORREY PINES RD
LA JOLLA CA
92037-1027
US

IV. Provider business mailing address

1544 CLOVIS CT
CHULA VISTA CA
91913-1506
US

V. Phone/Fax

Practice location:
  • Phone: 858-554-9100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number73156
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: