Provider Demographics
NPI:1720596414
Name:NO, HEE SUN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:HEE
Middle Name:SUN
Last Name:NO
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 S LA FAYETTE PARK PL APT 210
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-1328
Mailing Address - Country:US
Mailing Address - Phone:213-477-0500
Mailing Address - Fax:
Practice Address - Street 1:269 S LAFAYETTE PARK PL
Practice Address - Street 2:210
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057
Practice Address - Country:US
Practice Address - Phone:213-477-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77764183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty