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General NPI Number Information
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NPI Number | 1831411859
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Entity Type | Individual
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Provider Name | BOSUN CHUNG PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 02/17/2010
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 11201 BENTON ST BLDG 1
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City | LOMA LINDA
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State | CA
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Zip | 92357-1003
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Country | US
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Telephone | 909-825-7084
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Fax |
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Provider Business Mailing Address
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Address Line | 2169 HEDGEROW LN
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City | CHINO HILLS
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State | CA
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Zip | 91709-1710
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Country | US
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Telephone |
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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 | 1835P1300X
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Taxonomy Name | Psychiatric Pharmacist
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License Number | 60569
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 60569
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License Number State | CA
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