Organization
SUNG SOHN
Active
Other names
Ecoterra Hoilistic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MYRA SOHN (OWNER PHARMACIST)
(909) 624-8580
Entity
Organization
Contact information
Practice address
1 N INDIAN HILL BLVD STE 101, CLAREMONT, CA 91711-4769
(909) 624-8580
(909) 624-8615
Mailing address
1 N INDIAN HILL BLVD STE 101, CLAREMONT, CA 91711-4769
(909) 624-8580
(909) 624-8615
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PHY48921
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5637941
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/24/2010
Last updated
11/10/2010
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