Provider Demographics
NPI:1821514431
Name:PARK, CHOONG SUNG (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHOONG SUNG
Middle Name:
Last Name:PARK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18031 E LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-3114
Mailing Address - Country:US
Mailing Address - Phone:303-396-8706
Mailing Address - Fax:
Practice Address - Street 1:100 N 50TH AVE
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-8300
Practice Address - Country:US
Practice Address - Phone:303-637-0350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO21884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist