Provider Demographics
NPI:1457663528
Name:CHUNG, ANNE C (RPH)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:C
Last Name:CHUNG
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 1:500 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-2302
Mailing Address - Country:US
Mailing Address - Phone:213-623-5820
Mailing Address - Fax:213-489-6647
Practice Address - Street 1:500 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-2302
Practice Address - Country:US
Practice Address - Phone:213-623-5820
Practice Address - Fax:213-489-6647
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2024-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40932183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist