Kyung Woo Chun
Individual provider Active NPI Pharmacist · Mather, CA
NPI 1194409706 · NPPES record last updated Jun 14, 2023
Key facts
- NPI
- 1194409706
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 69739571701 (UT)
- Practice address
- 10535 Hospital Way BLDG 647
Mather, CA 95655-4200 - Phone
- (916) 843-9165
- NPI assigned
- Jun 14, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69739571701 | UT | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 69739571701 | UT | Yes |
Addresses
Primary practice location
10535 Hospital Way BLDG 647
Mather, CA 95655-4200
Mailing address
731 16TH St Apt 202
Sacramento, CA 95814-2030
Phone (801) 696-6564
Other providers in Mather, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.