Provider Demographics
NPI:1770063398
Name:CHU, KIN LIM (RPH)
Entity type:Individual
Prefix:
First Name:KIN
Middle Name:LIM
Last Name:CHU
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 1:1823 W ORANGETHORPE AVE
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-4405
Mailing Address - Country:US
Mailing Address - Phone:714-871-3040
Mailing Address - Fax:714-871-4808
Practice Address - Street 1:1823 W ORANGETHORPE AVE
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-4405
Practice Address - Country:US
Practice Address - Phone:714-871-3040
Practice Address - Fax:714-871-4808
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA317933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy