Active NPI
Soon R Chung
- Community/Retail Pharmacy
- Gardena, CA
National Provider Identifier
1003851320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PHY48764
- Legal business name
- SOON R CHUNG
- Doing business as
- GARDENA MEDICAL PHARMACY
- Practice address
- 1045 W Redondo Beach Blvd
Suite 300
Gardena, CA 90247-4128 - Phone
- (310) 515-6570
- Fax
- (310) 515-6549
- NPI assigned
- Jun 19, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Soon R Chung, R.PH
- Title
- Owner
- Phone
- (310) 515-6570
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHY48764 | CA | Primary |
Addresses
Primary practice location
1045 W Redondo Beach Blvd
Suite 300
Gardena, CA 90247-4128
Mailing address
1045 W Redondo Beach Blvd
Suite 300
Gardena, CA 90247-4128
Phone (310) 515-6570
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0570158 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names 1
- GARDENA MEDICAL PHARMACY
National Provider Directory
National Provider Directory- Tax ID family
- Cal Med Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Los Angeles, CA
- NPI 1396037826
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1003851320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1045 W REDONDO BEACH BLVD",
"address_2": "SUITE 300",
"city": "GARDENA",
"state": "CA",
"postal_code": "902474128",
"telephone_number": "310-515-6570",
"fax_number": "310-515-6549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 W REDONDO BEACH BLVD",
"address_2": "SUITE 300",
"city": "GARDENA",
"state": "CA",
"postal_code": "902474128",
"telephone_number": "310-515-6570",
"fax_number": "310-515-6549"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOON R CHUNG",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-19",
"last_updated": "2023-03-07",
"status": "A",
"authorized_official_last_name": "CHUNG",
"authorized_official_first_name": "SOON",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "310-515-6570",
"authorized_official_credential": "R.PH"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "CA",
"license": "PHY48764",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
"identifier": "0570158",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "GARDENA MEDICAL PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.