Provider Demographics
NPI:1902376320
Name:KANG, JULIA JUHEE (PHARM D)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:JUHEE
Last Name:KANG
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5415 MEAD DR
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-1390
Mailing Address - Country:US
Mailing Address - Phone:909-222-5848
Mailing Address - Fax:
Practice Address - Street 1:5415 MEAD DR
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-1390
Practice Address - Country:US
Practice Address - Phone:909-222-5848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79789183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist