Provider Demographics
NPI:1558161174
Name:JI, RYAN SUNGHUN (PHARMD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:SUNGHUN
Last Name:JI
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27438 RIVERSIDE LN
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-1890
Mailing Address - Country:US
Mailing Address - Phone:323-336-5821
Mailing Address - Fax:
Practice Address - Street 1:1740 S VICTORIA AVE
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-6592
Practice Address - Country:US
Practice Address - Phone:805-644-1833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90801183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist