Provider Demographics
NPI:1942307350
Name:EAST WEST DRUGS
Entity Type:Organization
Organization Name:EAST WEST DRUGS
Other - Org Name:SO-CAL MEDICAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYU YOON
Authorized Official - Middle Name:
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:213-384-8909
Mailing Address - Street 1:2405 W 8TH ST SUITE 103
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-5016
Mailing Address - Country:US
Mailing Address - Phone:213-384-8909
Mailing Address - Fax:213-384-4942
Practice Address - Street 1:2405 W 8TH ST STE 103
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-5016
Practice Address - Country:US
Practice Address - Phone:213-384-8909
Practice Address - Fax:213-384-4942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY474063336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0529020001Medicare NSC