Healthcare Provider Details

I. General information

NPI: 1811807639
Provider Name (Legal Business Name): HYE JI KIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12291 WASHINGTON BLVD STE 101
WHITTIER CA
90606-2549
US

IV. Provider business mailing address

12291 WASHINGTON BLVD STE 101
WHITTIER CA
90606-2549
US

V. Phone/Fax

Practice location:
  • Phone: 562-945-4166
  • Fax: 562-696-8578
Mailing address:
  • Phone: 562-945-4166
  • Fax: 562-696-8578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number92521
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: