NPIMap

Organization Active NPI

Sue Jung Inc

  • Community/Retail Pharmacy
  • Los Angeles, CA
National Provider Identifier
1962576488
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY48285 Issued in CA
Legal business name
SUE JUNG INC
Doing business as
SUPERMARKET PHARMACY #2
Practice address
325 1/2 S Western Ave
Los Angeles, CA 90020-3804
Phone
(213) 385-3321
Fax
(213) 385-3612
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Authorized official

Name
Sang Jeon
Title
Owner/President
Phone
(213) 385-3321

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY48285 CA Primary

Addresses

Primary practice location

325 1/2 S Western Ave
Los Angeles, CA 90020-3804

Mailing address

325 1/2 S Western Ave
Los Angeles, CA 90020-3804
Phone (213) 385-3321

Other identifiers 1

IdentifierTypeStateIssuer
0519871OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • SUPERMARKET PHARMACY #2 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ethical Drug2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1962576488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 1/2 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203804",
            "telephone_number": "213-385-3321",
            "fax_number": "213-385-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 1/2 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203804",
            "telephone_number": "213-385-3321",
            "fax_number": "213-385-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUE JUNG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "JEON",
        "authorized_official_first_name": "SANG",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "213-385-3321"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY48285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0519871",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUPERMARKET PHARMACY #2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 22, 2012; 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.