Active NPI
Eileen Jeong
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1659683100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 64134
- Practice address
- 1225 Wilshire Blvd
Los Angeles, CA 90017-1901 - Phone
- (213) 977-2121
- NPI assigned
- Jul 12, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 64134 | CA | Primary |
Addresses
Primary practice location
1225 Wilshire Blvd
Los Angeles, CA 90017-1901
Mailing address
60 Scented Violet
Irvine, CA 92620-7302
Phone (858) 349-3277
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 |
|---|---|---|---|
| 64134 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731628800000",
"number": "1659683100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 SCENTED VIOLET",
"city": "IRVINE",
"state": "CA",
"postal_code": "926207302",
"telephone_number": "858-349-3277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 WILSHIRE BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900171901",
"telephone_number": "213-977-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEONG",
"first_name": "EILEEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-12",
"last_updated": "2024-11-15",
"certification_date": "2024-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "64134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.