Individual
MICHELLE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
1200 GARDEN VIEW RD, SUITE 200, ENCINITAS, CA 92024-2477
(760) 536-7682
Mailing address
1200 GARDEN VIEW RD, SUITE 200, ENCINITAS, CA 92024-2477
Taxonomy
Speciality
Code
Description
License number
State
1835X0200X
Oncology Pharmacist
Primary
61162
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B9574529
DRIVERS LICENSE
CA
Enumeration date
07/08/2015
Last updated
08/22/2016
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