Healthcare Provider Details

I. General information

NPI: 1063340040
Provider Name (Legal Business Name): RICHARD YONG
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13193 CENTRAL AVE STE 120
CHINO CA
91710-4179
US

IV. Provider business mailing address

1015 FULLER DR
CLAREMONT CA
91711-1497
US

V. Phone/Fax

Practice location:
  • Phone: 909-573-0123
  • Fax:
Mailing address:
  • Phone: 626-298-5512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number46018
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: