Healthcare Provider Details
I. General information
NPI: 1174533657
Provider Name (Legal Business Name): ALAN SHOJI YAYESAKI PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10535 HOSPITAL WAY INPATIENT PHARMACY, MATHER HOSPITAL
MATHER CA
95655-4200
US
IV. Provider business mailing address
7744 OAKSHORE DR
SACRAMENTO CA
95831-5793
US
V. Phone/Fax
- Phone: 916-843-7060
- Fax: 916-843-7349
- Phone: 916-395-4254
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | RPH 35436 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: