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NPI Code Detail

MEDICARE: KYUNG MIN PHARMD

MEDICARE: KYUNG MIN 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
1183500000XPharmacist53405CA

General Provider Information

NPI Number : 1184111320
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYUNG MIN PHARMD
Provider Business Mailing Address
First Line : 6250 VALLEY SPRINGS PKWY
Second Line :
City : RIVERSIDE
State : CA
Zip : 92507-0970
Country : US
Telephone Number : 951-653-2969
Fax Number : 951-697-1005
Provider Business Practice Location Address
First Line : 6250 VALLEY SPRINGS PKWY
Second Line :
City : RIVERSIDE
State : CA
Zip : 92507-0970
Country : US
Telephone Number : 951-653-2969
Fax Number : 951-697-1005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2018
Last Update Date : 04/13/2018

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Directions to “ KYUNG MIN PHARMD” Practice Location

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