Provider Demographics
NPI:1588395727
Name:HUR, ALLISON RAN (PHARMD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:RAN
Last Name:HUR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15434 ILLORA DR
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-4834
Mailing Address - Country:US
Mailing Address - Phone:714-315-5209
Mailing Address - Fax:
Practice Address - Street 1:15434 ILLORA DR
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-4834
Practice Address - Country:US
Practice Address - Phone:714-315-5209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85058183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA85058OtherPHARMACIST REGISTRATION #