MEDICARE: RANDI YE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	86788	CA

General Provider Information

NPI Number	:	1588386536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDI YE

Provider Business Mailing Address
First Line	:	1179 PARK AVE APT G
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-5258
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5916 BOWCROFT ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90016-4302
Country	:	US
Telephone Number	:	800-874-5881
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2022
Last Update Date	:	09/16/2022

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Directions to “ RANDI YE ” Practice Location

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