MEDICARE: DR. KIM SO-CHE PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	53182	CA

General Provider Information

NPI Number	:	1083796700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIM SO-CHE PHARMD

Provider Business Mailing Address
First Line	:	1990 41ST AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94116-1101
Country	:	US
Telephone Number	:	415-753-7400
Fax Number	:	415-753-0164

Provider Business Practice Location Address
First Line	:	1380 HOWARD ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94103-2638
Country	:	US
Telephone Number	:	415-255-3659
Fax Number	:	415-252-3036

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	10/27/2018

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