Provider Demographics
NPI:1811101413
Name:KIM, STEVEN YONGJIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:YONGJIN
Last Name:KIM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 W COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-1302
Mailing Address - Country:US
Mailing Address - Phone:626-282-6954
Mailing Address - Fax:
Practice Address - Street 1:2207 W COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-1302
Practice Address - Country:US
Practice Address - Phone:626-282-6954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9699171100000X
CA49310183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No171100000XOther Service ProvidersAcupuncturist