Organization
KIM SON PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM CHI NGUYEN (PIC)
(626) 571-5967
Entity
Organization
Contact information
Practice address
625 E VALLEY BLVD, SUITE J, SAN GABRIEL, CA 91776-3591
(626) 571-5967
(626) 571-5968
Mailing address
625 E VALLEY BLVD, STE J, SAN GABRIEL, CA 91776-3591
(626) 571-5967
(626) 571-5968
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0578522
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
PHA345770
—
CA
Enumeration date
11/03/2006
Last updated
02/19/2009
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