Provider Demographics
NPI:1235141441
Name:RONSTIN INC
Entity type:Organization
Organization Name:RONSTIN INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONG
Authorized Official - Middle Name:H
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:323-582-5171
Mailing Address - Street 1:7119 SEVILLE AVE STE D
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-4997
Mailing Address - Country:US
Mailing Address - Phone:323-582-5171
Mailing Address - Fax:323-582-5296
Practice Address - Street 1:7119 SEVILLE AVE STE D
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-4997
Practice Address - Country:US
Practice Address - Phone:323-582-5171
Practice Address - Fax:323-582-5296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY468173336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA468170Medicaid
CAPHA468170Medicaid