Provider Demographics
NPI:1851614408
Name:SHIN, SUNNY H (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:SUNNY
Middle Name:H
Last Name:SHIN
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 1:13531 ACORO PL
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-8833
Mailing Address - Country:US
Mailing Address - Phone:562-229-1215
Mailing Address - Fax:
Practice Address - Street 1:13531 ACORO PL
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-8833
Practice Address - Country:US
Practice Address - Phone:562-229-1215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 48239183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist