Provider Demographics
NPI:1720309446
Name:SUH, YUNKYUNG
Entity Type:Individual
Prefix:
First Name:YUNKYUNG
Middle Name:
Last Name:SUH
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 1:1825 S CENTRE CITY PKWY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-6525
Mailing Address - Country:US
Mailing Address - Phone:760-738-4236
Mailing Address - Fax:760-738-2650
Practice Address - Street 1:1825 S CENTRE CITY PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-6525
Practice Address - Country:US
Practice Address - Phone:760-738-4236
Practice Address - Fax:760-738-2650
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54282183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist