Healthcare Provider Details

I. General information

NPI: 1144778978
Provider Name (Legal Business Name): ANGELA YEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2016
Last Update Date: 09/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9250 TOWNE CENTRE DR UNIT 1
SAN DIEGO CA
92121-3004
US

IV. Provider business mailing address

9250 TOWNE CENTRE DR UNIT 1
SAN DIEGO CA
92121-3004
US

V. Phone/Fax

Practice location:
  • Phone: 909-667-9519
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number74781
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: