Organization
LEE S KIM
Active
Other names
Beach Professional Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LEE SUNG KIM PHARMACIST (OWNER)
(714) 848-4447
Entity
Organization
Contact information
Practice address
17742 BEACH BLVD, SUITE 100, HUNTINGTON BEACH, CA 92647-6818
(714) 848-4447
(718) 843-9149
Mailing address
17742 BEACH BLVD, SUITE 100, HUNTINGTON BEACH, CA 92647-6818
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY37348
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0529478
OTHER ID NUMBER
—
05
—
PHA373480
—
CA
Enumeration date
10/27/2006
Last updated
07/16/2008
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