Provider Demographics
NPI:1215253687
Name:UNG, KIM (PHARMD)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:UNG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2865 ATLANTIC AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-7408
Mailing Address - Country:US
Mailing Address - Phone:562-933-0590
Mailing Address - Fax:562-933-0624
Practice Address - Street 1:2701 ATLANTIC AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2701
Practice Address - Country:US
Practice Address - Phone:562-933-2757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-10
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA571411835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist