NPIMap

Individual provider Active NPI

Kyungjoo Koo

  • Pharmacist
  • Los Angeles, CA
National Provider Identifier
1740637131
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
65836 Issued in CA
Practice address
440 S Vermont Ave Ste 109
Los Angeles, CA 90020-1987
Phone
(213) 388-4100
Fax
(213) 388-4200
NPI assigned
May 16, 2016
Last updated
May 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 65836 CA Primary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 65836 CA

Addresses

Primary practice location

440 S Vermont Ave Ste 109
Los Angeles, CA 90020-1987

Mailing address

440 S Vermont Ave Ste 109
Los Angeles, CA 90020-1987
Phone (213) 388-4100

Other names 1

  • Mrs. Cecilia Kyungjoo Seo Other name

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

Practice roles

OrganizationSpecialtyStatusNew patients
VG Wellness Pharmacy, Inc. CurrentSince Dec 21, 2021 Accepting new patients
VG Wellness Pharmacy Inc CurrentSince Nov 21, 2021 Accepting new patients
Wellness Pharmacy Inc Past Accepting new patients
Wellness Pharmacy Inc Past Accepting new patients

Locations

440 S Vermont Ave
Ste 109
Los Angeles, CA 90020
Phone (213) 388-4100

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1463356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746403200000",
    "number": "1740637131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 S VERMONT AVE STE 109",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201987",
            "telephone_number": "213-388-4100",
            "fax_number": "213-388-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 S VERMONT AVE STE 109",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201987",
            "telephone_number": "213-388-4100",
            "fax_number": "213-388-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOO",
        "first_name": "KYUNGJOO",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-16",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "65836",
            "primary": true
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CA",
            "license": "65836",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CECILIA",
            "last_name": "SEO",
            "middle_name": "KYUNGJOO",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 May 5, 2025; 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.