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NPI Code Detail

MEDICARE: MRS. KIL O YU KIM

MEDICARE: MRS. KIL O YU KIM
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
1183500000XPharmacist41451CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902800816
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIL O YU KIM
Provider Business Mailing Address
First Line : 18339 A E COLIMA RD
Second Line :
City : ROWLAND HEIGHTS
State : CA
Zip : 91748-2762
Country : US
Telephone Number : 626-810-1056
Fax Number : 626-810-4470
Provider Business Practice Location Address
First Line : 18339 A E COLIMA RD
Second Line :
City : ROWLAND HEIGHTS
State : CA
Zip : 91748-2762
Country : US
Telephone Number : 626-810-1056
Fax Number : 626-810-4470
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 01/16/2009

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