Healthcare Provider Details
I. General information
NPI: 1437808904
Provider Name (Legal Business Name): RANDALL DAVID YEE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/22/2022
Last Update Date: 03/16/2023
Certification Date: 03/16/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2425 GEARY BLVD
SAN FRANCISCO CA
94115-3358
US
IV. Provider business mailing address
3149 CASA DE CAMPO APT 113
SAN MATEO CA
94403-2121
US
V. Phone/Fax
- Phone: 415-833-2000
- Fax:
- Phone: 510-378-6293
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 82970 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: