Provider Demographics
NPI:1265941116
Name:KIM, HYUN JUNG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HYUN JUNG
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:EVELYN
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:24416 N 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-1887
Mailing Address - Country:US
Mailing Address - Phone:877-546-5779
Mailing Address - Fax:877-546-5780
Practice Address - Street 1:24416 N 19TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-1887
Practice Address - Country:US
Practice Address - Phone:877-546-5779
Practice Address - Fax:877-546-5780
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS022752183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist