Provider Demographics
NPI:1801085824
Name:UN, SANDRA HEON (PHARMD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:HEON
Last Name:UN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 N VERMONT AVE
Mailing Address - Street 2:SUITE 237
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5337
Mailing Address - Country:US
Mailing Address - Phone:323-783-7878
Mailing Address - Fax:323-783-5506
Practice Address - Street 1:1515 N VERMONT AVE
Practice Address - Street 2:SUITE 237
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5337
Practice Address - Country:US
Practice Address - Phone:323-783-7878
Practice Address - Fax:323-783-5506
Is Sole Proprietor?:No
Enumeration Date:2007-10-16
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60325183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist