Provider Demographics
NPI:1497595995
Name:CHIU, ANTHONY SUNGHONG (PHARMD)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:SUNGHONG
Last Name:CHIU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 S STATE COLLEGE BLVD UNIT 2080
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5862
Mailing Address - Country:US
Mailing Address - Phone:714-624-6433
Mailing Address - Fax:
Practice Address - Street 1:25011 ALESSANDRO BLVD
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92553-4312
Practice Address - Country:US
Practice Address - Phone:951-485-1116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH79841183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist