Provider Demographics
NPI:1578898003
Name:KIM, ANNE DUCKSOOK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:DUCKSOOK
Last Name:KIM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ANNE
Other - Middle Name:D
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:5881 WARNER AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-4657
Mailing Address - Country:US
Mailing Address - Phone:714-846-5291
Mailing Address - Fax:714-846-8936
Practice Address - Street 1:5881 WARNER AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-4657
Practice Address - Country:US
Practice Address - Phone:714-846-5291
Practice Address - Fax:714-846-8936
Is Sole Proprietor?:No
Enumeration Date:2009-10-17
Last Update Date:2014-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA290181835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist