Organization
SOON R. CHUNG
Active
Other names
Grand Ave Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SOON R CHUNG R.PH (OWNER)
(213) 746-4114
Entity
Organization
Contact information
Practice address
1400 S GRAND AVE, #100, LOS ANGELES, CA 90015-3048
(213) 746-4114
(213) 746-4465
Mailing address
1400 S GRAND AVE, #100, LOS ANGELES, CA 90015-3048
(213) 746-4114
(213) 746-4465
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY46585
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5615971
NCPDP
—
05
—
PHA465850
—
CA
Enumeration date
08/30/2005
Last updated
03/07/2023
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