Healthcare Provider Details

I. General information

NPI: 1508730847
Provider Name (Legal Business Name): YIEN-HAW AO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 S PRICE RD
CHANDLER AZ
85286-7201
US

IV. Provider business mailing address

2225 S PRICE RD
CHANDLER AZ
85286-7201
US

V. Phone/Fax

Practice location:
  • Phone: 480-752-5615
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS015839
License Number StateAZ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: