RICHARDSARAK SOR DUONG (NPI# 1912439217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912439217 |
| Entity Type | Individual |
| Full Name | RICHARDSARAK SOR DUONG |
| Practice Address |
1670 E 120th St Los Angeles CA 90059-3026 |
| Mailing Address |
1544 Remembrance Dr Perris CA 92571-2936 |
| Practice Telephone | 4243381965 |
| Mailing Telephone | 7142326700 |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2020-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 390200000X | Student in an Organized Health Care Education/Training Program | CA | Student, Health Care | |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
76700 | CA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 93687825A06036 | 05 |
| Street Address |
1670 E 120TH ST |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90059-3026 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275559528 | Clemens S Hong | Internal Medicine | 1670 E 120th St, Los Angeles, CA 90059-3026 | 2006-07-13 |
| 1528670072 | Takema Cox | Student in an Organized Health Care Education/Training Program | 1670 E 120th St, Los Angeles, CA 90059-3026 | 2020-08-17 |
| 1215575873 | Lauren Andrea Tuason | Pharmacy | 1670 E 120th St, Los Angeles, CA 90059-3026 | 2019-12-13 |
| 1881244101 | Jwch Institute, Inc | Clinic/Center | 1670 E 120th St, West Support Bldg #14 Fl 1, Los Angeles, CA 90059-3026 | 2019-09-18 |
| 1043873250 | Wendy Olivia Glass Givens | Social Worker | 1670 E 120th St, Los Angeles, CA 90059-3026 | 2019-04-15 |
| 1932662533 | Ian L Hao | Student in an Organized Health Care Education/Training Program | 1670 E 120th St, Los Angeles, CA 90059-3026 | 2019-04-10 |
| 1669935342 | Felisha Eugenio | Student in an Organized Health Care Education/Training Program | 1670 E 120th St, Los Angeles, CA 90059-3026 | 2019-04-10 |
| 1437611571 | Jesse Gomez | Student in an Organized Health Care Education/Training Program | 1670 E 120th St, Los Angeles, CA 90059-3026 | 2019-04-05 |
| 1659833960 | Issareekorn Glaewketgarn | Student in an Organized Health Care Education/Training Program | 1670 E 120th St, Los Angeles, CA 90059-3026 | 2019-04-04 |
| 1477015949 | Won Seok Shin | Student in an Organized Health Care Education/Training Program | 1670 E 120th St, Los Angeles, CA 90059-3026 | 2019-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235759788 | Juan Jimenez Jr. | Technician, Pathology | 1860 E 120th St, Los Angeles, CA 90059 | 2020-04-24 |
| 1538717780 | Donald O Nwanze | Pharmacist | Mlk Outpatient Center (pharmacy), 1670 East 120th Street, Los Angeles, CA 90059 | 2019-08-30 |
| 1295391050 | Sheela Hoyle | Counselor | 836 East Saucer Lane, Los Angeles, CA 90059 | 2019-05-16 |
| 1750852471 | Carlos Tovar Sr. | Community Health Worker | 1720 E 120st, Los Angeles, CA 90059 | 2018-12-06 |
| 1699293910 | Amy Caryn Bolenbaugh | Recreation Therapist | 1720 E 120th Street, Los Angeles, CA 90059 | 2017-09-07 |
| 1417475757 | Scott Lee Jones | Recreation Therapist | Augustus F. Hawkins, 1720 E. 120th Street, Rm. 2196, Los Angeles, CA 90059 | 2017-09-07 |
| 1881118859 | Darlene Renee Tillman | Speech-Language Pathologist | 1670 E 120th Strret, Los Angeles, CA 90059 | 2017-08-01 |
| 1609306430 | Valda Therese Flores | Registered Nurse | 1670 E. 120th Street, Los Angeles, CA 90059 | 2017-06-14 |
| 1093244006 | Bongsill Chung | Registered Nurse | 1670 East 120th St, Los Angeles, CA 90059 | 2017-06-05 |
| 1730573395 | Apollonia Godoy | Registered Nurse | 1670 E. 120th St, 4th Floor, Module A, Los Angeles, CA 90059 | 2015-03-22 |
| Find all providers in zip 90059 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104304765 | Alexander J Kellogg | Pharmacist | 236 S Los Angeles St Apt 334b, Los Angeles, CA 90012-3780 | 2018-08-04 |
| 1528564697 | Bonnie Lee | Pharmacist | 4640 Richelieu Ter, Los Angeles, CA 90032-3245 | 2018-04-05 |
| 1205347150 | Mee Kyoung Kim | Pharmacist | 3511 W Olympic Blvd Ste 102, Los Angeles, CA 90019-3563 | 2017-10-18 |
| 1922533231 | Edward Jai | Pharmacist | 550 S Vermont Ave Ste 903, Los Angeles, CA 90020-1912 | 2017-04-24 |
| 1346601036 | Jarrin Kean Cheng | Pharmacist | 4755 Templeton St Apt 2122, Los Angeles, CA 90032-2146 | 2016-03-09 |
| 1457745820 | Stephanie Mok | Pharmacist | 1100 N State St Rm 1b311, Los Angeles, CA 90033-5000 | 2015-03-24 |
| 1558655480 | Peyman Kharazi | Pharmacist | 1921 Glendon Ave, Apt 301, Los Angeles, CA 90025-4696 | 2011-06-08 |
| 1538489133 | Ng Patricia Lin | Pharmacist | 245 South Fetterly Avenue, Los Angeles, CA 90022 | 2010-06-04 |
| 1366772816 | Maria Kootsikas | Pharmacist | 1502 S. Crescent Heights Boulevard, Los Angeles, CA 90035-3816 | 2010-01-06 |
| 1912131210 | Dwight J Song | Pharmacist | 2018 Griffith Park Blvd, Apt #. 124, Los Angeles, CA 90039-3563 | 2009-05-14 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90059 |
Please comment or provide details below to improve the information on RICHARDSARAK SOR DUONG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.