Healthcare Provider Details

I. General information

NPI: 1780598342
Provider Name (Legal Business Name): KIMBERLY HAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11980 TELEGRAPH RD STE 102
SANTA FE SPRINGS CA
90670-6087
US

IV. Provider business mailing address

2553 SAN SIMON ST
TUSTIN CA
92782-8005
US

V. Phone/Fax

Practice location:
  • Phone: 877-872-4844
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH46643
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: