Healthcare Provider Details

I. General information

NPI: 1750567665
Provider Name (Legal Business Name): JULIE HYUNJU RYU PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2008
Last Update Date: 04/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 LAKESIDE DR
FOSTER CITY CA
94404-1147
US

IV. Provider business mailing address

333 LAKESIDE DR
FOSTER CITY CA
94404-1147
US

V. Phone/Fax

Practice location:
  • Phone: 650-522-5938
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00069000
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number62098
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: