Provider Demographics
NPI:1942329057
Name:KIM, DAVID DAI YOUNG (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID DAI YOUNG
Middle Name:
Last Name:KIM
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20539 S VERMONT AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-3108
Mailing Address - Country:US
Mailing Address - Phone:310-515-2117
Mailing Address - Fax:
Practice Address - Street 1:3074 E FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-5828
Practice Address - Country:US
Practice Address - Phone:323-277-8388
Practice Address - Fax:323-277-8384
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 42214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist