Healthcare Provider Details

I. General information

NPI: 1386027084
Provider Name (Legal Business Name): SUJIN JEUN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSIE JEUN

II. Dates (important events)

Enumeration Date: 06/30/2015
Last Update Date: 06/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 BRUNDAGE LN
BAKERSFIELD CA
93304-2949
US

IV. Provider business mailing address

1520 BRUNDAGE LN
BAKERSFIELD CA
93304-2949
US

V. Phone/Fax

Practice location:
  • Phone: 661-327-4265
  • Fax: 661-327-0534
Mailing address:
  • Phone: 661-327-4265
  • Fax: 661-327-0534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberCA071094
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: