Provider Demographics
NPI:1841330040
Name:SUNG, ALAN T (R PH)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:T
Last Name:SUNG
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2264 SHELLEY AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-2526
Mailing Address - Country:US
Mailing Address - Phone:408-559-0265
Mailing Address - Fax:
Practice Address - Street 1:900 KIELY BLVD
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5329
Practice Address - Country:US
Practice Address - Phone:408-236-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH31830183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist