Active NPI
Sung Jun Moon
- Pharmacist
- Northridge, CA
National Provider Identifier
1982474649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 88483
- Practice address
- 18300 Roscoe Blvd
Northridge, CA 91325-4105 - Phone
- (818) 885-8500
- NPI assigned
- Jan 4, 2024
- Sex
- Male
- Sole proprietor
- No
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 | 88483 | CA | Primary |
Addresses
Primary practice location
18300 Roscoe Blvd
Northridge, CA 91325-4105
Mailing address
3953 Abella St
La Crescenta, CA 91214-2320
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 |
|---|---|---|---|
| 88483 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704326400000",
"number": "1982474649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3953 ABELLA ST",
"city": "LA CRESCENTA",
"state": "CA",
"postal_code": "912142320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18300 ROSCOE BLVD",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913254105",
"telephone_number": "818-885-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "SUNG JUN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-01-04",
"last_updated": "2024-01-04",
"certification_date": "2024-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "88483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northridge, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.