Healthcare Provider Details

I. General information

NPI: 1801750542
Provider Name (Legal Business Name): JUN HONG MIN
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: ROY MIN

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10621 CARMENITA RD
SANTA FE SPRINGS CA
90670-4017
US

IV. Provider business mailing address

1530 BONNIE JEAN LN
LA HABRA HEIGHTS CA
90631-8666
US

V. Phone/Fax

Practice location:
  • Phone: 562-298-0044
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number91871
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: