Healthcare Provider Details

I. General information

NPI: 1174175160
Provider Name (Legal Business Name): SHERRY YANG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 09/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 N EL CIELO RD
PALM SPRINGS CA
92262-6972
US

IV. Provider business mailing address

9686 BEACON POINTE DR
RANCHO CUCAMONGA CA
91737-8911
US

V. Phone/Fax

Practice location:
  • Phone: 760-320-8814
  • Fax:
Mailing address:
  • Phone: 626-348-6752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number78687
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: