Sung Sohn

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PHY48921 Issued in CA

Legal business name

SUNG SOHN

Practice address

1 N Indian Hill Blvd Ste 101
Claremont, CA 91711-4769

Phone

(909) 624-8580

Fax

(909) 624-8615

NPI assigned

May 24, 2010

Organization subpart

No

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

Authorized official

Name

Myra Sohn

Title

Owner Pharmacist

Phone

(909) 624-8580

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ecoterra Hoilistic Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289347200000",
    "number": "1780903286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 N INDIAN HILL BLVD STE 101",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114769",
            "telephone_number": "909-624-8580",
            "fax_number": "909-624-8615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 N INDIAN HILL BLVD STE 101",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917114769",
            "telephone_number": "909-624-8580",
            "fax_number": "909-624-8615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNG SOHN",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-24",
        "last_updated": "2010-11-10",
        "status": "A",
        "authorized_official_last_name": "SOHN",
        "authorized_official_first_name": "MYRA",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "909-624-8580"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "CA",
            "license": "PHY48921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5637941",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ecoterra Hoilistic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sandra Jean Stuckey, P.T.
• Duane W Styles, MD
• Cassianna Miranda Summers, AMFT
• Jennifer Chia June Sun, M.D.
• Jenny C Sun, DDS
• Irene Riley Sung, M.D.
• Chanuwat M. Suntalus, PA-C
• Nathan Swan-Prung
• Marianne I. Talukdar, D.D.S.
• Gina Elizabeth Tarango, MASTERS DEGREE

• Compounding Pharmacy in Claremont, CA
• Providers in Claremont, CA by specialty
• Compounding Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; 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.