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General NPI Number Information
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NPI Number | 1932586963
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Entity Type | Individual
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Provider Name | GLORIA SONG CHA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 04/28/2015
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Last Update Date | 02/16/2021
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Provider Practice Location Address
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Address Line | 1505 N EDGEMONT ST FL 2
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City | LOS ANGELES
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State | CA
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Zip | 90027-5209
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Country | US
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Telephone | 323-783-4690
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Fax |
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Provider Business Mailing Address
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Address Line | 1505 N EDGEMONT ST FL 2
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City | LOS ANGELES
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State | CA
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Zip | 90027-5209
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Country | US
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Telephone | 323-783-4690
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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 | 71245
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License Number State | CA
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