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General NPI Number Information
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NPI Number | 1790152114
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Entity Type | Organization
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Legal Business Name | JOANNA J KIM PHARMACIST INC
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 1750 PACIFIC AVE STE A
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City | LONG BEACH
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State | CA
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Zip | 90813-1715
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Country | US
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Telephone | 562-599-5292
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Fax | 562-599-1893
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Provider Business Mailing Address
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Address Line | 1750 PACIFIC AVE
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City | LONG BEACH
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State | CA
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Zip | 90813-1715
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Country | US
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Telephone | 562-599-5292
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Fax | 562-599-1893
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Authorized Official
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Title or Position | AUTHORIZED OFFICAL
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Name | JOANNA J KIM
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Credential |
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Telephone | 562-599-5292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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