Provider Demographics
NPI:1497279863
Name:CHUNG, LENA (PHARMD)
Entity Type:Individual
Prefix:
First Name:LENA
Middle Name:
Last Name:CHUNG
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 1:27818 CLINTON KEITH RD
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-8554
Mailing Address - Country:US
Mailing Address - Phone:951-704-1124
Mailing Address - Fax:951-704-1134
Practice Address - Street 1:27818 CLINTON KEITH RD
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8554
Practice Address - Country:US
Practice Address - Phone:951-704-1124
Practice Address - Fax:951-704-1134
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist