Kim, Gene

Kim, Gene is an sole proprietor health care provider with primary practice located at 100 E Main St , San Jacinto CA 92583-4228. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Kim, Gene can be contacted via phone (951) 654-9393.

Contact Information

Primary practice address
100 E Main St San Jacinto CA 92583-4228
Phone: (951) 654-9393
Fax: (951) 654-9394
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 54767 California

Profile Details

NPI number 1316057243
LBN Legal business name Kim, Gene
Credentials PHARMD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 30th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316057243 NPPES
California MEDICAID PHA463750

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