Healthcare Provider Details

I. General information

NPI: 1578092144
Provider Name (Legal Business Name): YINTAT WILLIAM KHO PHARM D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2017
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8010 2ND ST
PARAMOUNT CA
90723-3404
US

IV. Provider business mailing address

8010 2ND ST
PARAMOUNT CA
90723-3404
US

V. Phone/Fax

Practice location:
  • Phone: 562-531-1313
  • Fax: 888-623-7130
Mailing address:
  • Phone: 562-531-1313
  • Fax: 888-623-7130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH49713
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number49713
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: