Provider Demographics
NPI:1750404083
Name:KIM, MEE KYUNG (RPH)
Entity type:Individual
Prefix:MS
First Name:MEE KYUNG
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-1768
Mailing Address - Country:US
Mailing Address - Phone:415-333-5135
Mailing Address - Fax:415-333-5712
Practice Address - Street 1:1830 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-1768
Practice Address - Country:US
Practice Address - Phone:415-333-5135
Practice Address - Fax:415-333-5712
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 52370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist