Active NPI
Christopher Chung
- Pharmacist
- Mission Hills, CA
National Provider Identifier
1588020820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 74913
- Practice address
- 11165 Sepulveda Blvd
Mission Hills, CA 91345-1125 - Phone
- (626) 837-5592
- NPI assigned
- Dec 31, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051.298887 | IL | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 051.298887 | IL | |
| Pharmacist | 183500000X | 74913 | CA | Primary |
Addresses
Primary practice location
11165 Sepulveda Blvd
Mission Hills, CA 91345-1125
Mailing address
11165 Sepulveda Blvd
Mission Hills, CA 91345-1125
Phone (626) 837-5592
Other practice location 1
1901 W Harrison St
Department of Pharmacy, LL-170
Chicago, IL 60612-3714
Phone (312) 864-2466
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 74913 | Other | CA | CALIFORNIA PHARMACIST ID |
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 |
|---|---|---|---|
| 74913 | CA | MD | Pharmacist |
| 051.298887 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618963200000",
"number": "1588020820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11165 SEPULVEDA BLVD",
"city": "MISSION HILLS",
"state": "CA",
"postal_code": "913451125",
"telephone_number": "626-837-5592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11165 SEPULVEDA BLVD",
"city": "MISSION HILLS",
"state": "CA",
"postal_code": "913451125",
"telephone_number": "626-837-5592"
}
],
"practiceLocations": [
{
"address_1": "1901 W Harrison St",
"address_2": "Department of Pharmacy, LL-170",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606123714",
"country_code": "US",
"telephone_number": "312-864-2466",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHUNG",
"first_name": "CHRISTOPHER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-12-31",
"last_updated": "2021-04-21",
"certification_date": "2021-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.298887",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "IL",
"license": "051.298887",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "74913",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA PHARMACIST ID",
"identifier": "74913",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mission Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.