Provider Demographics
NPI:1437683554
Name:KUNG, ALISON (RPH)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:KUNG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 W COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-1305
Mailing Address - Country:US
Mailing Address - Phone:626-576-3900
Mailing Address - Fax:626-576-4259
Practice Address - Street 1:2400 W COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-1305
Practice Address - Country:US
Practice Address - Phone:626-576-3900
Practice Address - Fax:626-576-4259
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49219183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist