Active NPI
Jung Heui Shin Koh
- Ambulatory Care Pharmacist
- Lawndale, CA
National Provider Identifier
1952836926
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 60903
- Practice address
- 15718 Hawthorne Blvd
Lawndale, CA 90260-2640 - Phone
- (310) 970-7440
- Fax
- (310) 970-7446
- NPI assigned
- Apr 26, 2017
- 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 |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 60903 | CA | Primary |
Addresses
Primary practice location
15718 Hawthorne Blvd
Lawndale, CA 90260-2640
Mailing address
15718 Hawthorne Blvd
Lawndale, CA 90260-2640
Phone (310) 970-7440
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60903 | Other | CA | PHARMACIST |
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 |
|---|---|---|---|
| 60903 | CA | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients | |
| Garfield Beach CVS, L.L.C. | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493164800000",
"number": "1952836926",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15718 HAWTHORNE BLVD",
"city": "LAWNDALE",
"state": "CA",
"postal_code": "902602640",
"telephone_number": "310-970-7440",
"fax_number": "310-970-7446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15718 HAWTHORNE BLVD",
"city": "LAWNDALE",
"state": "CA",
"postal_code": "902602640",
"telephone_number": "310-970-7440",
"fax_number": "310-970-7446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN KOH",
"first_name": "JUNG HEUI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-26",
"last_updated": "2017-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "CA",
"license": "60903",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST",
"identifier": "60903",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawndale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.