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NPI Code Detail

MEDICARE: KYE OK KIM PHARM. D

MEDICARE: KYE OK KIM PHARM. D
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
1183500000XPharmacist52686CA

General Provider Information

NPI Number : 1568712636
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYE OK KIM PHARM. D
Provider Business Mailing Address
First Line : 12350 CARMEL MOUNTAIN RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92128-4616
Country : US
Telephone Number : 858-675-0930
Fax Number :
Provider Business Practice Location Address
First Line : 12350 CARMEL MOUNTAIN RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92128-4616
Country : US
Telephone Number : 858-675-0930
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2012
Last Update Date : 09/14/2012

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Directions to “ KYE OK KIM PHARM. D” Practice Location

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