Chan Kyo Kim | Bakersfield, CA • PECOS Search

Chan Kyo Kim

Pharmacist

Pharmacy Service Providers

1520 Brundage Ln, Bakersfield, CA 93304-2949

PECOS Enrollment

Based on the most recent information from CMS, provider Chan Kyo Kim does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1003454802
Provider Type
Individual
Full Name
Kim, Chan Kyo
Credential
PHARMD

Gender
Male
Sole Proprietor
No
Enumeration Date
12/12/2019
Last Updated
12/12/2019

Contact Information

Practice Location

1520 Brundage Ln, Bakersfield, CA 93304-2949

Unlisted Fax

Mailing Location

11325 Park Square Dr Apt M208, Bakersfield, CA 93311-8875

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 183500000X Primary	Description Pharmacist Pharmacy Service Providers	License 810250 California