Healthcare Provider Details
I. General information
NPI: 1487516704
Provider Name (Legal Business Name): SOOCHUNG CAROLYN OH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/25/2025
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
603 N WILMOT RD # 151
TUCSON AZ
85711-2701
US
IV. Provider business mailing address
9037 N 28TH ST
PHOENIX AZ
85028-4702
US
V. Phone/Fax
- Phone: 520-324-2535
- Fax:
- Phone: 520-324-2535
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208U00000X |
| Taxonomy | Clinical Pharmacology Physician |
| License Number | S017816 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: