Provider Demographics
NPI:1427591957
Name:KIM, JANE JIHYEON (PHARM D)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:JIHYEON
Last Name:KIM
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 E BLITHEDALE AVE
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2032
Mailing Address - Country:US
Mailing Address - Phone:415-388-6354
Mailing Address - Fax:415-388-0326
Practice Address - Street 1:230 E BLITHEDALE AVE
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2032
Practice Address - Country:US
Practice Address - Phone:415-388-6354
Practice Address - Fax:415-388-0326
Is Sole Proprietor?:No
Enumeration Date:2016-12-01
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75826183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist