Sophia Chu

Individual provider Active NPI Pharmacist · Dana Point, CA

NPI 1023624632 · NPPES record last updated Dec 8, 2020

Key facts

NPI
1023624632
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
64416 (CA)
Practice address
32900 Pacific Coast Hwy
Dana Point, CA 92629-3464
Phone
(949) 489-9030
NPI assigned
Sep 18, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
64416CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Garfield Beach CVS, L.L.C. Past
since Sep 20, 2020
Accepting new patients
Garfield Beach CVS, L.L.C. Past
since Sep 20, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 64416 CA Yes

Addresses

Primary practice location

32900 Pacific Coast Hwy
Dana Point, CA 92629-3464

Mailing address

32900 Pacific Coast Hwy
Dana Point, CA 92629-3464
Phone (626) 429-8999

Other providers in Dana Point, CA

All providers in Dana Point, CA · Pharmacist in California

Sources for this page

Verify at the official NPI Registry.