Provider Demographics
NPI:1356569404
Name:WOORI PHARMACY, INC.
Entity type:Organization
Organization Name:WOORI PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:R.PH.
Authorized Official - Prefix:DR
Authorized Official - First Name:SANG
Authorized Official - Middle Name:JUNG
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:213-384-6323
Mailing Address - Street 1:266 S HARVARD BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-4374
Mailing Address - Country:US
Mailing Address - Phone:213-384-6323
Mailing Address - Fax:213-384-6340
Practice Address - Street 1:266 S HARVARD BLVD STE 120
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-4374
Practice Address - Country:US
Practice Address - Phone:213-384-6323
Practice Address - Fax:213-384-6340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY451303336L0003X, 332B00000X, 333600000X, 3336C0003X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA451300Medicaid
CAPHA451300Medicaid