Individual
RICHARDSARAK SOR DUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1670 E 120TH ST, LOS ANGELES, CA 90059-3026
(424) 338-1965
Mailing address
1544 REMEMBRANCE DR, PERRIS, CA 92571-2936
(714) 232-6700
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
76700
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
93687825A06036
—
CA
Enumeration date
03/28/2017
Last updated
06/16/2020
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