Provider Demographics
NPI:1619492972
Name:SO, KEVIN HOI-MAN (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:HOI-MAN
Last Name:SO
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4840 W DESERT INN RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-9125
Mailing Address - Country:US
Mailing Address - Phone:702-248-1854
Mailing Address - Fax:
Practice Address - Street 1:9851 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-7516
Practice Address - Country:US
Practice Address - Phone:702-946-1204
Practice Address - Fax:702-946-1208
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03237084183500000X
NV201631835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist