Healthcare Provider Details

I. General information

NPI: 1407775620
Provider Name (Legal Business Name): TINA YEH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24451 HEALTH CENTER DR
LAGUNA HILLS CA
92653-3689
US

IV. Provider business mailing address

1 SEA TER
NEWPORT COAST CA
92657-1018
US

V. Phone/Fax

Practice location:
  • Phone: 949-837-4500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH52984
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: