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General NPI Number Information
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NPI Number | 1992137806
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Entity Type | Individual
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Provider Name | CASSIE KIM PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 08/01/2013
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 1 JARRETT WHITE RD
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City | TRIPLER AMC
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State | HI
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Zip | 96859-5001
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Country | US
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Telephone | 808-655-6771
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Fax |
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Provider Business Mailing Address
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Address Line | 6900 PECOS RD
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89086-4400
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Country | US
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Telephone |
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PH3529
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH-3529
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License Number State | HI
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