MEDICARE: YU KYEONG JUNG RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH43993	CA

General Provider Information

NPI Number	:	1831548387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YU KYEONG JUNG RPH

Provider Business Mailing Address
First Line	:	4216 BEVERLY BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-4430
Country	:	US
Telephone Number	:	213-382-8899
Fax Number	:	213-382-8830

Provider Business Practice Location Address
First Line	:	4216 BEVERLY BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-4430
Country	:	US
Telephone Number	:	213-382-8899
Fax Number	:	213-382-8830

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2016
Last Update Date	:	06/06/2016

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Directions to “ YU KYEONG JUNG RPH” Practice Location

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