Healthcare Provider Details

I. General information

NPI: 1942571377
Provider Name (Legal Business Name): EVIE YANG PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2012
Last Update Date: 01/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4181 OCEANSIDE BLVD
OCEANSIDE CA
92056-6004
US

IV. Provider business mailing address

11505 CAMINITO LA BAR APT 96
SAN DIEGO CA
92126-6007
US

V. Phone/Fax

Practice location:
  • Phone: 760-536-7330
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number53495
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: