Provider Demographics
NPI:1396727822
Name:WHANG, CHUNG SOOK
Entity type:Individual
Prefix:MRS
First Name:CHUNG
Middle Name:SOOK
Last Name:WHANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16059 CRESTLINE DR
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-3457
Mailing Address - Country:US
Mailing Address - Phone:562-902-5840
Mailing Address - Fax:
Practice Address - Street 1:16059 CRESTLINE DR
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-3457
Practice Address - Country:US
Practice Address - Phone:562-902-5840
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 47621183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAROH 47621OtherPHARMACIST