Healthcare Provider Details

I. General information

NPI: 1356723142
Provider Name (Legal Business Name): SIKEAT YIP PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2015
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9961 SIERRA AVE., MOB#2, 6TH FLR
FONTANA CA
92335
US

IV. Provider business mailing address

9961 SIERRA AVE., MOB#2, 6TH FLR
FONTANA CA
92335
US

V. Phone/Fax

Practice location:
  • Phone: 909-427-5318
  • Fax:
Mailing address:
  • Phone: 909-427-5318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberRPH74058
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: