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General NPI Number Information
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NPI Number | 1518548411
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Entity Type | Individual
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Provider Name | JINA SUNG PHARMD
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Gender | Female
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Dates
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Enumeration Date | 04/21/2021
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 2010 E 1ST ST STE 120
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City | SANTA ANA
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State | CA
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Zip | 92705-4086
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Country | US
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Telephone | 714-954-1902
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Fax |
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Provider Business Mailing Address
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Address Line | 13900 STUDEBAKER RD APT 4
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City | NORWALK
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State | CA
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Zip | 90650-3573
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Country | US
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Telephone | 571-455-6862
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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 | RPH83822
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License Number State | CA
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