Provider Demographics
NPI:1477860773
Name:WU, KRYSTLE CHER PURIFICACION (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRYSTLE CHER
Middle Name:PURIFICACION
Last Name:WU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 N VERMONT AVE STE 237
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5329
Mailing Address - Country:US
Mailing Address - Phone:323-783-3398
Mailing Address - Fax:
Practice Address - Street 1:1515 N VERMONT AVE STE 237
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5329
Practice Address - Country:US
Practice Address - Phone:323-783-3398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA626711835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist