Provider Demographics
NPI:1407282395
Name:CHUNG, SERA (PHARM D, RPH)
Entity Type:Individual
Prefix:
First Name:SERA
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463 N BEDFORD DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4302
Mailing Address - Country:US
Mailing Address - Phone:310-247-0843
Mailing Address - Fax:310-247-0839
Practice Address - Street 1:463 N BEDFORD DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4302
Practice Address - Country:US
Practice Address - Phone:310-247-0843
Practice Address - Fax:310-247-0839
Is Sole Proprietor?:No
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66385183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist