Provider Demographics
NPI:1518225374
Name:LYNCH, KIRK JAMES (PHARMD)
Entity Type:Individual
Prefix:
First Name:KIRK
Middle Name:JAMES
Last Name:LYNCH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8969 SANTA MONICA BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-4934
Mailing Address - Country:US
Mailing Address - Phone:310-273-5126
Mailing Address - Fax:
Practice Address - Street 1:8969 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-4934
Practice Address - Country:US
Practice Address - Phone:310-273-5126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51650183500000X
IL051-286441183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist