Individual
KWANGSUN CHUN SHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15074 IMPERIAL HWY, LA MIRADA, CA 90638-1301
(562) 902-5580
(562) 902-5589
Mailing address
15074 IMPERIAL HWY, LA MIRADA, CA 90638-1301
(562) 902-5580
(562) 902-5589
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY46563
CA
Other
Enumeration date
03/18/2019
Last updated
03/18/2019
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