Provider Demographics
NPI:1376858480
Name:KIM, SUNG YEE
Entity Type:Individual
Prefix:
First Name:SUNG
Middle Name:YEE
Last Name:KIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 S HILL ST # 217
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3500
Mailing Address - Country:US
Mailing Address - Phone:213-680-2000
Mailing Address - Fax:213-680-2010
Practice Address - Street 1:255 S HILL ST
Practice Address - Street 2:217
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-3500
Practice Address - Country:US
Practice Address - Phone:213-680-2000
Practice Address - Fax:213-680-2010
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 52469183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist