Healthcare Provider Details

I. General information

NPI: 1669418315
Provider Name (Legal Business Name): YOUNG'S PHARMACY ,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7134 VAN NUYS BLVD
VAN NUYS CA
91405-3005
US

IV. Provider business mailing address

7134 VAN NUYS BLVD
VAN NUYS CA
91405-3005
US

V. Phone/Fax

Practice location:
  • Phone: 818-787-9339
  • Fax: 818-787-0189
Mailing address:
  • Phone: 818-787-9339
  • Fax: 818-787-0189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY36169
License Number StateCA

VIII. Authorized Official

Name: MRS. YOUNG SOOK SUNG
Title or Position: PRESIDENT
Credential: R.PH.
Phone: 818-787-9339