MEDICARE: YOUNG SOOK WON PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH52433	CA

General Provider Information

NPI Number	:	1811128952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOUNG SOOK WON PHARM.D.

Provider Business Mailing Address
First Line	:	3377 WILSHIRE BL #102B
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-1851
Country	:	US
Telephone Number	:	213-382-0032
Fax Number	:	213-382-0289

Provider Business Practice Location Address
First Line	:	3377 WILSHIRE BL #102B
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-1851
Country	:	US
Telephone Number	:	213-382-0032
Fax Number	:	213-382-0289

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2009
Last Update Date	:	06/02/2011

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