Provider Demographics
NPI:1013364751
Name:SUNG, YOUNG YOON
Entity Type:Individual
Prefix:
First Name:YOUNG YOON
Middle Name:
Last Name:SUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 PLAZA DEL AMO UNIT 14
Mailing Address - Street 2:#14
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-9346
Mailing Address - Country:US
Mailing Address - Phone:310-619-4269
Mailing Address - Fax:
Practice Address - Street 1:2800 PLAZA DEL AMO UNIT 14
Practice Address - Street 2:#14
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-9346
Practice Address - Country:US
Practice Address - Phone:310-619-4269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56795183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist