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General NPI Number Information
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NPI Number | 1003625021
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Entity Type | Individual
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Provider Name | YOUNG JOON PAK PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 2700 PARK AVE
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City | TUSTIN
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State | CA
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Zip | 92782-2708
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Country | US
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Telephone | 714-338-1942
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Fax |
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Provider Business Mailing Address
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Address Line | 169 ELKHORN
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City | IRVINE
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State | CA
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Zip | 92618-8891
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Country | US
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Telephone | 714-797-8280
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 90686
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License Number State | CA
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