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General NPI Number Information
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NPI Number | 1811324544
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Entity Type | Individual
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Provider Name | SOO JIN KIM PHARM.D
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Gender | Female
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Dates
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Enumeration Date | 09/26/2013
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Last Update Date | 09/26/2013
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Provider Practice Location Address
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Address Line | 14011 PALM DR
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City | DESERT HOT SPRINGS
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State | CA
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Zip | 92240-6845
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Country | US
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Telephone | 760-329-3634
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Fax |
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Provider Business Mailing Address
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Address Line | 2252 W LINCOLN AVE APT A3
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City | ANAHEIM
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State | CA
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Zip | 92801-6504
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Country | US
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Telephone | 714-345-8700
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 68667
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License Number State | CA
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