Provider Demographics
NPI:1295055432
Name:SHINPARK, MYUNGHEE (RPH)
Entity type:Individual
Prefix:MRS
First Name:MYUNGHEE
Middle Name:
Last Name:SHINPARK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:MY
Other - Middle Name:
Other - Last Name:SHINPARK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:13720 BEAR VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-8713
Mailing Address - Country:US
Mailing Address - Phone:760-955-2070
Mailing Address - Fax:760-955-6032
Practice Address - Street 1:13720 BEAR VALLEY RD
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-8713
Practice Address - Country:US
Practice Address - Phone:760-955-2070
Practice Address - Fax:760-955-6032
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 52894183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist