Sun Lake Drug

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHY19627 Issued in CA

Legal business name

SUN LAKE DRUG

Practice address

2860 W Sunset Blvd
Los Angeles, CA 90026-2126

Phone

(323) 662-1139

Fax

(323) 663-1223

NPI assigned

Feb 14, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dean G NG, PHARMDNPI 1356493316

Title

Pic

Phone

(323) 662-1139

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dean G NG, PHARMD

  • Pharmacist
  • Los Angeles, CA
  • NPI 1356493316
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104968098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900262126",
            "telephone_number": "323-662-1139",
            "fax_number": "323-663-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900262126",
            "telephone_number": "323-662-1139",
            "fax_number": "323-663-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN LAKE DRUG",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NG",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "323-662-1139",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY19627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA196270",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sun Bay Koreatown, LLC
• Sun Diagnostic
• Sun Drug Pharma Inc
• Sun Drug Pharma Inc
• Sun J Shin MD Inc
• Sun M Chung MD PC
• Sun-Triune Healthcare, Inc.
• Alexander Sun
• Amy Sun
• Annie Chin Sun, DPT

• Pharmacy in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.