Provider Demographics
NPI:1730391566
Name:NAM, MOON HYUN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MOON
Middle Name:HYUN
Last Name:NAM
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12291 E. WASHINGTON BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606
Mailing Address - Country:US
Mailing Address - Phone:562-945-4166
Mailing Address - Fax:562-696-8578
Practice Address - Street 1:12291 E. WASHINGTON BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2500
Practice Address - Country:US
Practice Address - Phone:562-945-4166
Practice Address - Fax:562-696-8578
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH39466183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist