Healthcare Provider Details

I. General information

NPI: 1801484076
Provider Name (Legal Business Name): JOHNSON HUNG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2021
Last Update Date: 01/04/2021
Certification Date: 01/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11301 WILSHIRE BLVD
LOS ANGELES CA
90073-1003
US

IV. Provider business mailing address

4150 ARCH DR APT 208
STUDIO CITY CA
91604-3205
US

V. Phone/Fax

Practice location:
  • Phone: 310-268-3244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number75144
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: