Provider Demographics
NPI:1346755824
Name:HONG, SOON IL (PHARMACIST)
Entity type:Individual
Prefix:
First Name:SOON IL
Middle Name:
Last Name:HONG
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 N WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-4108
Mailing Address - Country:US
Mailing Address - Phone:323-467-2101
Mailing Address - Fax:323-469-8615
Practice Address - Street 1:254 N WESTERN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-4108
Practice Address - Country:US
Practice Address - Phone:323-467-2101
Practice Address - Fax:323-469-8615
Is Sole Proprietor?:No
Enumeration Date:2017-12-06
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063590183500000X
CA83757183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist