Provider Demographics
NPI:1700542297
Name:KIM, CHRISTINE YOUNG (PHARM D)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:YOUNG
Last Name:KIM
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10566 SUNLAND BLVD UNIT 1
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-1949
Mailing Address - Country:US
Mailing Address - Phone:213-407-4231
Mailing Address - Fax:
Practice Address - Street 1:37950 47TH ST E
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93552-3271
Practice Address - Country:US
Practice Address - Phone:661-285-9473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist