Healthcare Provider Details

I. General information

NPI: 1982362067
Provider Name (Legal Business Name): MAI YOKOTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2021
Last Update Date: 03/01/2024
Certification Date: 03/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2829 S GRAND AVE
LOS ANGELES CA
90007-3304
US

IV. Provider business mailing address

2829 S GRAND AVE
LOS ANGELES CA
90007-3304
US

V. Phone/Fax

Practice location:
  • Phone: 213-699-7000
  • Fax:
Mailing address:
  • Phone: 213-699-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH85426
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH85426
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: