Healthcare Provider Details

I. General information

NPI: 1790847853
Provider Name (Legal Business Name): YEA-LIAN HUANG PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 12/08/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34900 PASEO PADRE PARKWAY
FREMONT CA
94538
US

IV. Provider business mailing address

44824 TROUT CT
FREMONT CA
94539-6028
US

V. Phone/Fax

Practice location:
  • Phone: 510-248-3947
  • Fax:
Mailing address:
  • Phone: 510-248-3888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH49063
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: