Provider Demographics
NPI:1932236742
Name:JUNG, SAMMY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SAMMY
Middle Name:
Last Name:JUNG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16330 BENJAMIN CT
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-3779
Mailing Address - Country:US
Mailing Address - Phone:818-636-4311
Mailing Address - Fax:
Practice Address - Street 1:387 E AVENIDA DE LOS ARBOLES
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-2933
Practice Address - Country:US
Practice Address - Phone:805-492-1559
Practice Address - Fax:805-492-7281
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28825183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist