Active NPI
Kun Noun Yoeun
- Nutrition Support Pharmacist
- Long Beach, CA
National Provider Identifier
1376547281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Support Pharmacist
- License
- PHY 46714
- Practice address
- 916 E Pacific Coast Hwy
Long Beach, CA 90806-5626 - Phone
- (562) 218-7784
- Fax
- (562) 218-7686
- NPI assigned
- Jun 8, 2005
- Reactivated
- Mar 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Support Pharmacist | 1835N1003X | PHY 46714 | CA | Primary |
Addresses
Primary practice location
916 E Pacific Coast Hwy
Long Beach, CA 90806-5626
Mailing address
916 E Pacific Coast Hwy
Long Beach, CA 90806-5626
Phone (562) 218-7784
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DME03094F | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PHY 46714 | CA | MD | Nutrition Support Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sandy Medical Supply, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Durable Medical Equipment & Medical Supplies
- Long Beach, CA
- NPI 1437228822
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1376547281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "916 E PACIFIC COAST HWY",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908065626",
"telephone_number": "562-218-7784",
"fax_number": "562-218-7686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "916 E PACIFIC COAST HWY",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908065626",
"telephone_number": "562-218-7784",
"fax_number": "562-218-7686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOEUN",
"first_name": "KUN",
"middle_name": "NOUN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-08",
"last_updated": "2026-07-13",
"deactivation_date": "2006-03-21",
"reactivation_date": "2006-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "1835N1003X",
"taxonomy_group": "",
"desc": "Pharmacist, Nutrition Support",
"state": "CA",
"license": "PHY 46714",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DME03094F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.