Provider Demographics
NPI:1336417054
Name:CHUNG, LING-LING (PRH)
Entity Type:Individual
Prefix:MRS
First Name:LING-LING
Middle Name:
Last Name:CHUNG
Suffix:
Gender:F
Credentials:PRH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 MONTE VERDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-6121
Mailing Address - Country:US
Mailing Address - Phone:626-446-3850
Mailing Address - Fax:626-446-3850
Practice Address - Street 1:6325 ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91775-1933
Practice Address - Country:US
Practice Address - Phone:626-285-5107
Practice Address - Fax:626-285-5268
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH046059183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist