Healthcare Provider Details

I. General information

NPI: 1831037001
Provider Name (Legal Business Name): BRANDON YIP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3044 GAINSBOROUGH DR
PASADENA CA
91107-5577
US

IV. Provider business mailing address

3044 GAINSBOROUGH DR
PASADENA CA
91107-5577
US

V. Phone/Fax

Practice location:
  • Phone: 323-719-9125
  • Fax:
Mailing address:
  • Phone: 323-719-9125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number53364
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: