Healthcare Provider Details

I. General information

NPI: 1316758147
Provider Name (Legal Business Name): SAU BIK YAU RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2025
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 S ALVARADO ST
LOS ANGELES CA
90057-2211
US

IV. Provider business mailing address

705 N STONEMAN AVE APT 3
ALHAMBRA CA
91801-1467
US

V. Phone/Fax

Practice location:
  • Phone: 213-483-8741
  • Fax: 213-483-8743
Mailing address:
  • Phone: 626-297-8230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number55076
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: