Individual ProviderJin Hwan KimPharmacistPharmacy Service ProvidersPractice Address101 Bodin Cir, Travis Afb, CA 94535-1809(707) 423-7119PECOS EnrollmentBased on the most recent information from CMS, provider Jin Hwan Kim does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:10 AM.Profile DetailsProvider ID1649412719Provider TypeIndividualFull NameKim, Jin HwanTitleDr.CredentialPHARMDGenderMaleSole ProprietorNoEnumeration Date4/3/2009Last Updated9/18/2023Contact InformationPractice LocationPractice Address101 Bodin Cir, Travis Afb, CA 94535-1809Phone(707) 423-7119FaxUnlisted FaxMailing LocationMailing Address101 Bodin Cir, Travis Afb, CA 94535-1809Phone(707) 423-7119FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicenseA1-0004100DelawareCode183700000XDescriptionPharmacy TechnicianPharmacy Service ProvidersLicenseUnlisted Issuer