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NPI Code Detail

MEDICARE: MINJEONG KIM PHARMD

MEDICARE: MINJEONG KIM 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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist80712CA

General Provider Information

NPI Number : 1588263727
Entity Type Code : Individual
Provider Name (Legal Business Name) : MINJEONG KIM PHARMD
Provider Business Mailing Address
First Line : 1020 UNIVERSITY AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-7325
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1020 UNIVERSITY AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-7325
Country : US
Telephone Number : 619-298-5181
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2020
Last Update Date : 05/27/2026

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Directions to “ MINJEONG KIM PHARMD” Practice Location

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