Provider Demographics
NPI:1013500321
Name:KIM, YOUNG GAINZ (PHARMD)
Entity Type:Individual
Prefix:
First Name:YOUNG
Middle Name:GAINZ
Last Name:KIM
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 1:3538 TORRANCE BLVD UNIT 106
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4894
Mailing Address - Country:US
Mailing Address - Phone:805-832-0400
Mailing Address - Fax:
Practice Address - Street 1:3538 TORRANCE BLVD UNIT 106
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4894
Practice Address - Country:US
Practice Address - Phone:805-832-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83868333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy